Employment Practitioner Agreement

EMPLOYMENT PRACTITIONER AGREEMENT

This Employment Practitioner Agreement (the Agreement) is entered into by and between Employer Name: (hereinafter "Employer") and Practitioner Name: . The effective date of this Agreement is .

Personal Information

Position Information

Anticipated Start Date:   Employment Classification: Employee Independent Contractor   Work Schedule: Full-time Part-time

Licensure and Credentials

Issuing State:   Expiration Date:

Duties; Professional Standards

Practitioner shall perform professional services consistent with the standard of care for the practitioner's profession, in accordance with applicable law, Employer policies, and any applicable clinical protocols. Practitioner shall maintain valid licensure, credentials, and malpractice insurance as required by Employer. Practitioner shall not engage in conduct that would adversely affect privileges or licensure.

Term and Termination

The term of this Agreement is at-will and may be terminated by either party at any time, with or without cause, subject to applicable notice requirements. Employer may suspend or terminate privileges immediately upon learning of conduct, impairment, or credentialing issues that present patient safety concerns. Practitioner may resign by providing written notice as set forth in Employer policy.

Confidentiality; Records; Intellectual Property

Practitioner shall preserve the confidentiality of all patient, business, and proprietary information in accordance with law and Employer policy. Practitioner assigns to Employer any clinical documentation, records, or work product created in the course of employment that are the property of Employer. Practitioner must comply with Employer policies governing recordkeeping and information security.

Indemnification; Insurance

Practitioner shall maintain professional liability insurance in amounts required by Employer while rendering services under this Agreement. Practitioner agrees to indemnify Employer against claims arising from Practitioner’s negligent or willful acts, except to the extent such claims are the direct result of Employer’s own negligence or breach of this Agreement.

Compensation; Benefits; Expense Reimbursement

Compensation, benefits eligibility, and expense reimbursement are set forth in Employer's policies and any separate compensation addendum. Any bonuses, incentive compensation, or benefits are subject to Employer's discretion and applicable plans. Practitioner is responsible for complying with payroll and benefits enrollment procedures.

Employment History

Education

References (Professional)

Legal Disclosures & Acknowledgements

At-Will Employment: Practitioner acknowledges that employment (or engagement) with Employer is at-will, and either party may terminate the relationship at any time, with or without cause, except as otherwise provided by statute or a written agreement signed by both parties.

Equal Opportunity: Employer is an equal opportunity employer. Practitioner acknowledges Employer's commitment to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, or other protected characteristics as defined by law.

Background Checks and Authorization: Practitioner authorizes Employer to obtain employment verifications, reference checks, credentialing verifications, criminal background checks, drug and alcohol screenings, and any other pre-employment or ongoing screenings required by Employer policy or law. Practitioner certifies that all information provided in this Agreement and in any accompanying documents is true, accurate, and complete.

I authorize Employer and its agents to contact my prior employers, licensing boards, references, and other entities to verify statements made in this Agreement and in my application materials. I release such entities from liability for providing truthful information.

Applicant Certification

I certify that the information provided in this Agreement, and in any supporting documentation, is true and complete to the best of my knowledge. I understand that any material misrepresentation, omission, or falsification may be grounds for denial of employment or termination of engagement and may be subject to penalties under law.

Dispute Resolution; Governing Law

This Agreement shall be governed by the laws of the state in which the primary practice location is located. Except where prohibited by law, disputes arising under this Agreement shall be resolved first through good-faith negotiation and then, if unresolved, by binding arbitration conducted in accordance with the rules agreed by the parties.

Miscellaneous Provisions

Entire Agreement: This Agreement, together with any written addenda or exhibits executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior agreements.

Notices: Notices required by this Agreement shall be in writing and delivered in accordance with Employer policy or by certified mail to the address on file.

Additional Terms / Special Agreements

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