Can a locum sign electronically?

Yes. Electronic signatures are legally enforceable under the federal ESIGN Act (15 U.S.C. §7001) and state UETA laws in most jurisdictions. Ensure intent, consent, signer attribution, and reliable record retention to meet the ESIGN four‑part test.

Is a Business Associate Agreement required?

If the locum will access PHI, a HIPAA Business Associate Agreement is required and should be executed before access. Follow HIPAA privacy and record retention rules (45 CFR §164.530(j)).

Do healthcare locum contracts need notarization?

Contracts generally do not require notarization to be valid, but some facilities or payer processes may request notarized signatures. Remote Online Notarization rules vary by state; verify local notary requirements in advance.

What if tax information is missing?

If a required TIN is missing or incorrect, payers may apply 24% backup withholding and report to the IRS. Provide a completed W-9 upon request to avoid withholding and reporting issues.

How long must I keep signed agreements?

Retain agreements at least three years for IRS purposes (IRC §6501(a)) and six years for HIPAA-related records (45 CFR §164.530(j)); longer retention may be required by state law.

How can the agreement be revoked or canceled?

Follow the contract’s termination clause: typically written notice for convenience, immediate termination for licensure loss or misconduct, and settlement of outstanding invoices per payment terms.

Electronic Signature
Templates
Healthcare
Healthcare Locums Terms Agreement

Healthcare Locums Terms Agreement

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

HEALTHCARE LOCUMS TERMS AGREEMENT

This Healthcare Locums Terms Agreement (Agreement) is entered into as of by and between Facility Name: and Locum Clinician: .

Parties and Contact Information

Facility Legal Name Facility Address for Notices Facility Primary Contact Facility Contact Phone & Email Locum Clinician Name Clinician Address Clinician Contact Phone & Email

Clinician Credentials & Licensure

Date of Birth Primary Specialty State Medical License Number(s) and State(s) DEA Number (if applicable)

Engagement, Scope, and Term

Facility engages Clinician to provide temporary professional clinical services as a locum tenens practitioner at Facility locations specified by Facility. The initial assignment begins on and is expected to continue through unless earlier terminated in accordance with this Agreement.

Scope of Services (Describe duties, schedule, on-call expectations)

Compensation, Billing, and Expenses

Rate and Payment Terms Minimum Shift or Call Requirements Invoicing and Payment Period Facility Reimbursable Expenses

Professional Standards, Insurance and Credentialing

Clinician represents and warrants that Clinician is duly licensed, certified, and privileged to perform the services described herein. Clinician shall maintain professional liability insurance with minimum limits of and shall provide certificates of insurance prior to the commencement of services and upon renewal.

Malpractice Insurance Carrier and Policy Number

Facility is responsible for initiating and completing any required facility credentialing, privileging, and orientation. Clinician shall cooperate fully and deliver requested documentation, including current license, DEA, controlled-substance registration where applicable, board certification, malpractice declarations, and background check authorizations.

Clinician NPI Number

Confidentiality, HIPAA, and PHI

Clinician shall comply with all federal and state laws governing the protection of protected health information and Facility policies, including but not limited to requirements to use, disclose and safeguard PHI only as permitted for treatment, payment and health care operations or as otherwise expressly authorized by Facility. Clinician acknowledges receipt of any applicable facility privacy policies and agrees to complete required HIPAA training prior to providing services.

HIPAA Acknowledgment: Clinician affirms understanding of HIPAA obligations and agrees to protect PHI in accordance with law and Facility policies.

Background Checks, Drug Screening, and Compliance

As a condition precedent to providing services, Clinician authorizes Facility to obtain or verify background checks, credentialing verification, and drug screening. Clinician must notify Facility immediately of any change in licensure status, disciplinary action, criminal charges, or license restrictions.

Clinician authorizes background and credential verification.
Clinician agrees to submit to drug screening as requested by Facility.

Independent Contractor; Taxes and Benefits

Clinician is engaged as an independent contractor. Clinician is solely responsible for all federal, state and local taxes arising from payments hereunder and shall not be treated as an employee of Facility for any purpose. Clinician is not entitled to employee benefits from Facility.

Indemnification and Liability

Each party agrees to indemnify, defend and hold harmless the other party and its officers, directors and employees from and against claims, liabilities, losses or expenses arising out of the indemnifying party's negligent acts or omissions, willful misconduct, or breach of this Agreement. Nothing in this Agreement will be construed to limit a party's liability for gross negligence or intentional misconduct.

Termination

This Agreement may be terminated by either party for convenience upon days' written notice, or immediately for material breach or loss of licensure. Obligations and provisions that by their nature survive termination shall survive.

Governing Law; Dispute Resolution

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to its conflict of law rules. Unless otherwise agreed in writing, disputes shall be resolved in the courts located in the jurisdiction specified above.

Notices

All notices required or permitted under this Agreement shall be in writing and shall be delivered to the addresses set forth below or to such other address as a party may designate by notice in accordance with this section.

Facility Notice Address Clinician Notice Address

Miscellaneous Provisions

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations and understandings. Any amendment must be in writing and signed by authorized representatives of both parties. If any provision is held invalid, the remainder shall remain in full force and effect.

Authorization Expiration Date (if applicable) Additional Terms or Special Instructions

Facility:

By:

Date:

Locum Clinician:

By:

Date:

What the Healthcare Locums Terms Agreement Is

A Healthcare Locums Terms Agreement is a written contract between a temporary healthcare professional (the locum) or staffing agency and a healthcare facility that sets the terms of a temporary assignment. It defines scope of services, clinical privileges, shift schedules, compensation and billing, licensing and credentialing expectations, malpractice and general liability insurance requirements, confidentiality and HIPAA compliance, tax and payment terms, termination rights, and dispute resolution. The agreement also states which party is responsible for credentialing, orientation, background checks, and timely submission of timesheets and invoices.

Why a Clear Locums Agreement Matters

A precise agreement reduces operational risk by documenting responsibilities, payment terms, credentialing timing, and compliance obligations under HIPAA and professional licensing rules.

Who Typically Completes This Agreement

Each signer should confirm licensing, insurance limits, and payroll or independent-contractor status before execution.

Locum clinicians: physicians, nurse practitioners, physician assistants, anesthetists, and allied health professionals who provide temporary coverage.
Staffing agencies: organizations that place clinicians and coordinate credentialing, scheduling, and invoicing with facilities.
Healthcare facilities: hospitals, clinics, long-term care, and emergency departments that engage temporary clinicians for coverage.

Core Sections to Include in the Agreement

A professional Healthcare Locums Terms Agreement organizes obligations into discrete sections so both parties understand expectations, compliance duties, and remedies.

Engagement Scope

Specify clinical duties, facility location, hours per shift, on-call obligations, and reporting relationships to avoid scope creep and credentialing disputes.

Compensation

Detail hourly/daily rates, overtime or premium pay, invoicing cycle, payment terms, and who pays travel, lodging, and fringe expenses.

Licensure & Credentials

Require current state license, DEA/controlled-substance registration if applicable, board certifications, and timeline for primary source verification by credentialing office.

Liability & Insurance

List required malpractice limits, tail or occurrence coverage, named insureds, and proof-of-insurance deadlines to protect both parties.

Compliance & Privacy

Include HIPAA obligations, BAA requirement for PHI handling, confidentiality clauses, and reporting processes for breaches or adverse events.

Termination & Disputes

Set notice periods, immediate-termination triggers (licensure loss, criminal charge), dispute resolution method, and governing law selection.

Essential Compliance and Security Items

HIPAA BAA: BAA required for PHI handling

ESIGN / UETA: Electronic signatures enforceable

Encryption: TLS 1.2/1.3 in transit

Audit Trail: Timestamps and signer attribution

Access Controls: Role-based user access

Retention Policy: Secure, auditable document storage

Step-by-Step: Completing and Executing the Agreement

Follow this sequential process to prepare, verify, and finalize the agreement with minimal delays.

01

Prepare Documents: Gather license, NPI, CV, malpractice certificate.
02

Verify Credentials: Primary-source verify licensure and board status.
03

Agree Terms: Negotiate pay, scope, insurance limits.
04

Execute & Store: Sign electronically, distribute copies, archive securely.

Setting Up an Electronic Workflow

Configure fields and authentication to match compliance needs and the parties’ signing preferences.

Field	Configuration
Authentication Method	Email link, SMS code, or KBA
Signature Order	Sequential or parallel signing
Conditional Fields	Show fields based on role or answers
Auto Reminders	Set periodic reminder schedule

Where to Send the Executed Agreement

Route signed copies to the parties and to internal teams that require the record for payroll, credentialing, or compliance.

Staffing Agency: Retain copy for placement and invoicing records.
Facility HR/Credentialing: Store in provider file for privileging.
Payroll / Accounts Payable: Send invoices and signed rate terms here.
Clinical Department: Notify supervising department and add to scheduling.

Technical Options for Distribution and Signing

Ensure the vendor offers a BAA for HIPAA, audit logs for ESIGN compliance, and secure storage with AES-256 encryption.

File Formats: PDF and DOCX supported
Integrations: CRM, HRIS, and cloud storage
Authentication: Email, SMS, and stronger options

Key Deadlines and Timing Expectations

Track credentialing lead times and administrative deadlines early to avoid coverage gaps or payment delays.

Credentialing Lead Time:

Allow 30–90 days for primary source verification

License Expiration:

Renew before expiration date to avoid suspension

Timesheet Submission:

Submit by payroll cutoff to ensure timely pay

W-9 / Tax Info:

Provide W-9 upon payer request; no fixed federal deadline

Start Date Confirmation:

Confirm availability and clearances before first shift

Common Mistakes to Avoid

Submitting incorrect license numbers or expired credentials, which halts credentialing and prevents facility access.
Failing to attach required insurance certificates or naming the facility as additional insured when contract requires it.
Using unsigned or mismatched signature blocks that invalidate acceptance or trigger duplicate compensations.
Neglecting HIPAA BAA execution when PHI access is needed, increasing breach liability and regulatory exposure.

Principal Risks and Potential Penalties

I-9 Penalties: Civil fines $281–$2,789 per violation

Backup Withholding: 24% withholding for missing TIN

HIPAA Fines: Civil/criminal penalties for PHI breaches

Credentialing Delays: Loss of coverage or cancelled shifts

Insurance Gaps: Personal exposure for malpractice claims

Contract Disputes: Costly arbitration or litigation

eSignature Pricing and Feature Snapshot

Compare typical starting prices and basic capabilities for commonly used eSignature providers; signNow is listed first per platform conventions.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial, no card required	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Business Premium)	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA available)	Yes	Yes	Varies by plan	Varies by plan

Frequently Asked Questions

Answers to common questions about enforceability, HIPAA, notarization, tax forms, retention, and termination for locum agreements.

Need help? Contact support

Can a locum sign electronically?
Yes. Electronic signatures are legally enforceable under the federal ESIGN Act (15 U.S.C. §7001) and state UETA laws in most jurisdictions. Ensure intent, consent, signer attribution, and reliable record retention to meet the ESIGN four‑part test.
Is a Business Associate Agreement required?
If the locum will access PHI, a HIPAA Business Associate Agreement is required and should be executed before access. Follow HIPAA privacy and record retention rules (45 CFR §164.530(j)).
Do healthcare locum contracts need notarization?
Contracts generally do not require notarization to be valid, but some facilities or payer processes may request notarized signatures. Remote Online Notarization rules vary by state; verify local notary requirements in advance.
What if tax information is missing?
If a required TIN is missing or incorrect, payers may apply 24% backup withholding and report to the IRS. Provide a completed W-9 upon request to avoid withholding and reporting issues.
How long must I keep signed agreements?
Retain agreements at least three years for IRS purposes (IRC §6501(a)) and six years for HIPAA-related records (45 CFR §164.530(j)); longer retention may be required by state law.
How can the agreement be revoked or canceled?
Follow the contract’s termination clause: typically written notice for convenience, immediate termination for licensure loss or misconduct, and settlement of outstanding invoices per payment terms.

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