Use this telemedicine services agreement template to create a legally binding document between a medical doctor or hospital facility and a client (usually a third-party medical platform) hosting or receiving virtual medical services. Outline the responsibilities of both parties and protect medical professionals from liability.
This Telemedicine Agreement (the “Agreement”) dated (Enter date) (the “Effective Date”) is by and between [Sender.Company] (the “Medical Service Provider”), and [Client.FirstName] [Client.LastName] , (“Client”), collectively the “Parties” and each a “Party”.
The purpose of this Agreement is to utilize the technology that enables telemedicine in order to provide patients living in the serviced areas to get proper medical care from the Medical Service Provider without the inconvenience and expense, both financial and time, to travel to the Client’s address or location.
Both the undersigned agree to the following terms of this Agreement.
In telemedicine service agreements, physicians offering such services must hold the appropriate licenses to provide them. If they practice across state lines, they need to ensure that they’re compliant with the licensure laws of that state as well.
Medical Service Provider shall ensure that only licensed personnel shall provide medical services to the Client.
The Medical Service Provider shall have complete authority, management, and control over including, but not limited to, clinical diagnosis, procedure, treatment required or any other professional healthcare services necessary in connection with the provision of the telemedicine services in accordance with laws.
This section is set up for agreements between a medical practitioner and a platform that wishes to enlist the services of this Doctor. As such, it reflects that relationship. If you’re a doctor that wants to use this agreement for private consultations with clients, you can adjust these terms for that situation.
The client shall not control, direct, interfere, or supervise the Medical Service Provider in connection with the provision of medical services.
Client, when engaging with the Medical Service Provider, shall ensure that only properly licensed medical healthcare professionals shall be employed and utilized in conducting a diagnosis, procedure, treatment, or other healthcare services necessary in connection with the telemedicine services Agreement.
It is agreed that the Client shall be responsible for the payment to the Medical Service Provider of the following fees during the Term.
For all services agreed to be provided hereunder and for all representations, warranties and requirements hereunder, Client agrees to pay Medical Service Provider the fees and amounts set forth on Exhibit B (collectively, the “Fees”).
Medical Service Provider shall be allowed to terminate the service to a particular Member for non-compliance with any applicable rules, regulations or agreements regarding the use of the site or with applicable laws or regulations or to exercise other remedies allowed at law or in equity. Medical Service Medical Service Provider will notify the Client of any such instance, including the name of the Member and the reason for termination.
Notwithstanding any provision contained herein, this Agreement is not intended to:
Supervise any non-licensed medical professional or individual in the practice of medicine. Constitute the use of the medical license by anyone other than the licensed physician. Perform any act that is contrary to state and federal laws.Medical Service Provider shall remain entirely independent of Client as to:
Diagnosis and treatment of patients, Prescription, order, or administration of any drug or medicine, and All other medical, professional and ethical affairs of the Medical Service Provider.Any personal information collected and stored must comply with all Health Insurance Portability and Accountability Act (HIPAA) regulations and Protected Health Information (PHI) regulations.
Any proprietary information such as, but not limited to, relating to business operations, services, technology, and software, among others, that the Medical Service Provider may acquire from the Client through performance and within the effectiveness of this Agreement which is not considered public knowledge shall be recognized as Confidential Information.
Medical Service Provider shall not in any way disclose the Confidential Information without the prior written consent of the Client. In case of uncertainty, whether such information is considered confidential, it shall always be presumed confidential for the benefit and protection of the Parties.
A Medical Service Provider will secure and maintain professional liability insurance sufficient to satisfy any state-specific requirements where Services are delivered. In addition, the Client will maintain insurance of its employed or contracted healthcare Medical Service Provider in amounts that are substantially similar to the amounts outlined in this section. For non-physicians, Medical Service Provider provides liability coverage on a shared limits basis that is comparable and within industry-wide standards.
It is hereby stipulated and agreed to between Client and Medical Service Provider that with respect to any claim or action arising out of any service performed under or pursuant to this Agreement, each entity will only be liable for payment of that portion of any and all liability costs, expenses, demands, settlements or judgments resulting from the negligence actions or omissions of its own agents, officers and employees.
Each party to this Agreement (“Indemnifying Party”) shall indemnify and hold the other party to this Agreement (“Indemnified Party”) harmless from any and all claims asserted against the Indemnified Party (and all related liabilities, costs and expenses of any kind whatsoever, including but not limited to attorneys’ fees and court costs), to the extent arising out of:
The grossly negligent acts, omissions, or misconduct of the Indemnifying Party, its employees, or agents.
Non-compliance with any applicable federal or state law, rule or regulation by the Indemnifying Party, its employees or agents.
Any breach by the Indemnifying Party, its agents, employees, or servants of any material covenant or condition of this Agreement.