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Agreement with Health Care Worker as an Independent Contractor by pellcity27


									         Agreement with Health Care Worker as an Independent Contractor

Agreement made on the ___ day of __________, 20___, between (Name of Health
Care Worker) of (street address, city, county, state, zip code), referred to herein as
Contractor, and (Name of Health Care Corporation), a corporation organized and
existing under the laws of the state of (name of state), with its principal office located at
(street address, city, county, state, zip code), referred to herein as Provider.

Whereas, Provider is a provider of certain healthcare services (Provider Services),
including but not limited to vaccinations, screenings and health education, and uses the
services of qualified independent healthcare professionals such as

   Registered nurses,
   Licensed practical nurses,
   Nurse assistants,
   Medical assistants, and
   Phlebotomists to provide such services; and

Whereas, Provider desires to engage Contractor to provide certain Provider Services to
or on behalf of Provider's clients;

Now, therefore, for and in consideration of the mutual covenants contained in this
agreement, and other good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, the parties agree as follows:

1.     Engagement. Contractor hereby agrees to provide the Provider Services and
perform all obligations described in Section 3 of this Agreement, in conformance with
and as more particularly described in the Provider Independent Contractor's Manual
of Common Policies and Procedures (as the same may hereafter be revised,
modified or amended from time to time, the Manual) and elsewhere in this Agreement.

2.    Term of Engagement. The initial term of this Agreement shall be one year,
commencing on (date). Upon the expiration of the initial term, this Agreement shall be
automatically renewed for successive one-year terms unless otherwise terminated by
Provider or Contractor as provided for herein.

3.    Scope of Engagement. During the term of this Agreement, Contractor's
responsibilities shall include, but shall not be limited to, the following:

       A.      Administer Provider Services as appropriate, based on Contractor's
       professional experience, education, certifications and/or licenses, during the term
       of this Agreement including, but not limited to, certain health screenings,
       education and other healthcare and wellness services as may be provided by
       Provider to its clients, at the direction of the Provider medical director.
B.     Comply with and carry out all duties in conformance with the Provider
policies and procedures contained herein and in the Manual. The Contractor
hereby acknowledges that he/she has read and understands the Provider
policies and procedures that apply to him/her set forth in the Manual including,
but not limited to, those policies applicable to scheduling, shipping, payment,
time sheets, attire, clinic reports, general clinic and other procedures. The terms
of the Manual are incorporated herein by this reference.

C.      Maintain at all times, at Contractor's sole cost and expense, the necessary
and/or applicable licenses and/or certifications of Contractor's profession or as
otherwise necessary to perform under this Agreement, and make proof of such
certifications available for inspection by Provider upon request of Provider from
time to time.

D.     Be sufficiently familiar with, so as to properly use, Provider paperwork
including but not limited to education handouts, consent forms, clinic reports,
sheets, time sheets and aggregate forms.

E.      Comply at all times, at Contractor's sole cost and expense, with any and
all ethical requirements of the Contractor's profession and all federal, state and
local laws, ordinances, regulations and rules relating to, governing or regulating
the practice of Contractor's profession.

F.     Perform Provider Services and such other services, including but not
limited to supervisory, administrative and marketing services as are from time to
time assigned by Provider.

G.     Report any incidents in providing Provider Services immediately to
Provider on clinic report forms and as indicated in the Manual, whether minor or
major, including any clinic issues such as client or customer problems or
disagreements, scheduling and/or staff problems, equipment problems, etc.

H.      Obtain the appropriate informed consent from each individual receiving
Provider Services. Written consent forms must be obtained prior to an individual's
participation in certain Provider Services, including but not limited to
immunizations, cholesterol screening and other blood tests, colorectal screening
and health risk appraisals.

I.     Truthfully and accurately maintain and preserve such records and make,
on a timely basis, such reports as Provider may from time to time require.

J.     Comply with all other policies/procedures applicable to the specific
Provider Service Contractor agrees to provide throughout the term of this
Agreement. The Contractor will receive additional policies/procedures applicable
to specific Provider Services after the commencement of this Agreement as
Contractor agrees to provide additional Provider Services not previously provided
      by Contractor. All policies/procedures are hereby incorporated into this
      Agreement and Contractor is bound to comply with all such policies/procedures
      upon Contractor's receipt of them.

      K.     Maintain in strict confidence all client and customer information, including
      but not limited to, client and customer names, locations, numbers of shots
      administered and individual participants' results.

      L.    Fully account for all monies and other property of Provider of which
      Contractor may from time to time have custody and deliver same to Provider
      whenever and however directed.

      M.     Perform all Provider Services in a highly professional manner. The
      Contractor represents and warrants that he/she has never been terminated from
      previous employment or other engagement as a result of theft, misconduct,
      excessive tardiness or failure to follow the employer's or contractor's

4.     Fees and Expenses. In consideration of this engagement, Provider shall pay
Contractor a fee on a per diem basis, as more particularly set forth in the Manual. The
amounts set forth in the Manual include applicable reimbursements for time spent
marketing, training, traveling, preparing for and running clinics. Accordingly, no
additional expenses shall be reimbursed unless pre-approved by Provider in writing.

5.      Benefits. Because Contractor will be providing independent professional
healthcare services to Provider's clients as an independent contractor and not as an
employee of Provider, he/she shall not be entitled to participate in any benefit program
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