Consent Document Template

CONSENT AGREEMENT

Effective Date:

WHEREAS

WHEREAS, Client desires to grant limited consent to Provider to collect, use, store, disclose, or act upon Client information and materials as described herein for the purposes set forth below; and

WHEREAS, Provider represents that it has the necessary expertise, facilities, and authority to perform the services and to handle Client information in accordance with the terms of this Agreement; and

WHEREAS, the parties intend that this written Consent Agreement constitute the entire and binding authorization for the limited uses and disclosures described herein.

SCOPE OF WORK / CONSENTED ACTIVITIES

The Provider is authorized to perform the following activities and to use Client materials and information only as necessary to perform such activities. The Provider shall not use Client information for any purpose not described below without obtaining additional written consent from Client.

PAYMENT TERMS

Client agrees to compensate Provider according to the terms below. All amounts are due in United States dollars unless otherwise stated.

TERM AND TERMINATION

This Agreement commences on the Start Date and, unless earlier terminated in accordance with this Agreement, expires on the End Date set forth below.

Start Date:

End Date:

Either party may terminate this Agreement for material breach if the breach is not cured within the notice period above. Termination does not relieve Client of obligations to pay for services performed and expenses incurred prior to termination.

CONFIDENTIALITY

The parties agree that Confidential Information means any non-public information disclosed by one party to the other in connection with this Agreement, whether oral, written, electronic, or observed. Provider shall maintain Confidential Information in strict confidence, using at least the same degree of care as it uses to protect its own similar information, but not less than a reasonable degree of care.

Financial and billing information

Personal identifying information

Proprietary methods, trade secrets, or other business information

Exceptions: Confidential Information does not include information that is or becomes generally known to the public through no wrongful act of the receiving party, was known to the receiving party prior to disclosure, or is independently developed without access to the disclosing party's Confidential Information.

CONSENT AND LIMITATIONS

By signing below, Client grants Provider the limited and revocable consent to use and disclose Client information and materials as expressly set forth in this Agreement. This consent is limited to the specific purposes described in the Scope of Work and does not authorize broader uses or disclosures. Provider shall not sell Client information nor use it for advertising unrelated to the Scope of Work.

Revocation: Client may revoke this consent at any time by providing written notice to Provider. Revocation will be effective upon receipt, but will not affect disclosures or actions taken by Provider in good faith in reliance on this consent prior to receipt of revocation.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state identified below, without regard to its conflict of law principles.

ENTIRE AGREEMENT; MISCELLANEOUS

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations, and understandings, whether written or oral. No amendment shall be effective unless in writing and signed by duly authorized representatives of both parties.

Severability: If any provision of this Agreement is held invalid or unenforceable, the remaining provisions will remain in full force and effect. Remedies are cumulative and do not exclude any other remedies available at law or in equity.

REPRESENTATIONS AND AUTHORITY

Each party represents and warrants that it has full power and authority to enter into this Agreement and that the individual signing below is authorized to bind the party for whom they sign. Each party agrees to provide further assurances as reasonably requested to effectuate the terms of this Agreement.

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