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Occupational Therapist Agreement

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INDEPENDENT CONTRACTOR OCCUPATIONAL THERAPIST AGREEMENT

THIS AGREEMENT made and entered into on the date last written below, by and between (hereinafter "Employer"), and , an independent contractor (hereinafter "Occupational Therapist");

WHEREAS, the Employer desires to retain the services of Occupational Therapist, and Occupational Therapist desires to render services to the Employer, upon the terms and conditions hereinafter stated:

NOW, THEREFORE, the parties hereto, intending to be legally bound hereby, do hereby promise and agree as follows:

SECTION 1 – SCOPE OF DUTIES TO BE PROVIDED

1.1 Term. Employer agrees to hire Occupational Therapist, at will, for a term commencing on , 20 and continuing until terminated in accordance with Section 4 of this agreement.

1.2 Duties. Occupational Therapist agrees to perform work for the Employer on the terms and conditions set forth in this agreement and agrees to devote all necessary time and attention (reasonable periods of illness excepted) to the performance of the duties specified in this agreement. Occupational Therapist's duties shall include the following:

Occupational Therapist further agrees that in all aspects of such work, Occupational Therapist shall comply with the policies, standards, regulations of the Employer from time to time established, and shall perform the duties assigned faithfully, intelligently, to the best of his/her ability, and in the best interest of the Employer.

SECTION 2 – CONFIDENTIALITY

2.1 Confidentiality. Occupational Therapist acknowledges and agrees that all client information is owned by Employer, including amounts paid therefore, client and customer lists, and other Employer data and information related to its business (hereinafter collectively "Confidential Information") are valuable assets of the Employer. Except for disclosures required to be made to advance the business of the Employer and information which is a matter of public record, Occupational Therapist shall not, during the term of this Agreement or after the termination of this Agreement, disclose any Confidential Information to any person or use any Confidential Information for the benefit of Occupational Therapist or any other person, except with the prior written consent of the Employer.

Employer understands that certain Confidential Information may be required to be disclosed to certain individuals: directors, officers, employees, agents, or advisors (collectively, Representatives) of Occupational Therapist. Occupational Therapist shall maintain records of the persons to whom Confidential Information is distributed, will inform all such persons of the confidential nature of the information, will direct them to treat such information in accordance with this agreement, will exercise such precautions or measures as may be reasonable in the circumstances to prevent improper use of Confidential Information by them, and will be responsible for any breaches by them of the provisions of this agreement.

The term “confidential information” does not include information that is or becomes publicly available (other than through breach of this Agreement) or information that is or becomes available to Occupational Therapist on a nonconfidential basis, provided that the source of such information was not known by Occupational Therapist (after such inquiry as would be reasonable in the circumstances) to be bound by a confidentiality agreement or other legal or contractual obligation of confidentiality with respect to such information.

In the event that Occupational Therapist or any of Occupational Therapist’s representatives, assigns, or agents are requested or required by law or legal process to disclose any of the Confidential Information, the party required to disclose such information shall provide Employer with prompt oral and written notice before making any disclosure. In addition, Confidential Information may be disclosed to the extent required in the course of inspections or inquiries by federal or state regulatory agencies to whose jurisdiction Occupational Therapist is subject and that have the legal right to inspect the files that contain the Confidential Information, and Occupational Therapist will advise Employer promptly upon such disclosure.

2.2 Return of Documents. Occupational Therapist acknowledges and agrees that all originals and copies of records, reports, documents, lists, plans, memoranda, notes and other documentation related to the business of the Employer or containing any Confidential Information shall be the sole and exclusive property of the Employer, and shall be returned to the Employer upon the termination of this Agreement or upon the written request of the Employer.

2.4 No Release. Occupational Therapist agrees that the termination of this Agreement shall not release Occupational Therapist from any obligations under Section 2.1 or 2.2.

SECTION 3 – COMPENSATION

3.1 Compensation. In consideration of all services to be rendered by Occupational Therapist to the Employer, the Employer shall pay to said the amount of $ per other .

3.2 Withholding; Other Benefits. Compensation paid pursuant to this Agreement shall not be subject to the customary withholding of income taxes and other employment taxes. Occupational Therapist shall be solely responsible for reporting and paying any such taxes. The Employer shall not provide Occupational Therapist with any coverage or participation in the Employer's accident and health insurance, life insurance, disability income insurance, medical expense reimbursement, wage continuation plans, or other fringe benefits provided to regular employees.

SECTION 4 - TERMINATION

4.1 Termination at Will. This Agreement may be terminated by the Employer immediately, at will, and in the sole discretion of Employer. Occupational Therapist may terminate this Agreement upon days written notice to Employer. This Agreement also may be terminated at any time upon the mutual written agreement of the Employer and Occupational Therapist.

SECTION 5 - INDEPENDENT CONTRACTOR STATUS

5.1 Occupational Therapist acknowledges that he/she is an independent contractor and is not an agent, partner, joint venturer nor employee of Employer. Occupational Therapist shall have no authority to bind or otherwise obligate Employer in any manner nor shall Occupational Therapist represent to anyone that it has a right to do so. Occupational Therapist further agrees that in the event that the Employer suffers any loss or damage as a result of a violation of this provision Occupational Therapist shall indemnify and hold harmless the Employer from any such loss or damage.

5.2 Assignment. The Occupational Therapist shall not assign any of his/her rights under this agreement, or delegate the performance of any of his/her duties hereunder, without the prior written consent of the Employer.

SECTION 6 - REPRESENTATIONS AND WARRANTIES OF OCCUPATIONAL THERAPIST

6.1 Occupational Therapist represents and warrants to the Employer that there is no employment contract or other contractual obligation to which Occupational Therapist is subject which prevents Occupational Therapist from entering into this Agreement or from performing fully Occupational Therapist's duties under this Agreement.

6.2 Occupational Therapist represents that he/she is licensed by the appropriate licensing agency for the profession and that he/she is in good standing with such agency.

SECTION 7 - INSURANCE

Physical Therapist shall obtain and maintain in force, at its own expense, throughout the performance of his/her/its obligations under this Agreement, insurance coverage against claims, regardless of when asserted, that may arise out of, or result from, Physical Therapist's operations in connection with the services or duties described above. This insurance shall include the following coverage(s) that is(are) checked below:

Physical Therapist agrees to provide worker's compensation insurance for Physical Therapist's employees and agents and agrees to hold harmless and indemnify Employer for any and all claims arising out of any injury, disability, or death of any of Physical Therapist's employees or agents.

SECTION 8 - MISCELLANEOUS PROVISIONS

8.1 The provisions of this Agreement shall be binding upon and inure to the benefit of the heirs, personal representatives, successors and assigns of the parties. Any provision hereof which imposes upon Occupational Therapist or Employer an obligation after termination or expiration of this Agreement shall survive termination or expiration hereof and be binding upon Occupational Therapist or Employer.

8.2 No waiver of any provision of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the party making the waiver.

8.3 This Agreement shall be governed by and shall be construed in accordance with the laws of the State of .

8.4 This Agreement constitutes the entire agreement between the parties pertaining to its subject matter and supersedes all prior contemporaneous agreements, representations and understandings of the parties. No supplement, modification or amendment of this Agreement shall be binding unless executed in writing by all parties.

8.5 Severability. If any provision of these policies and regulations or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of these policies and regulations which can be given effect without the invalid provision or application, and to this end the provisions of these policies and regulations are severable. In lieu thereof, there shall be added a provision as similar in terms to such illegal, invalid and unenforceable provision as may be possible and be legal, valid and enforceable.

WITNESS OUR SIGNATURES, this the day of , 20 .

EMPLOYER

OCCUPATIONAL THERAPIST

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What an Occupational Therapist Agreement Is and when it's used

An Occupational Therapist Agreement is a written contract that defines the professional relationship between an occupational therapist and a payer, employer, clinic, school, or client. It typically sets the scope of services, treatment settings, scheduling expectations, fees and billing, licensure and credential verification, confidentiality and HIPAA protections, insurance and liability allocation, and termination rights. The agreement documents responsibilities for clinical documentation, billing compliance, and data handling where protected health information (PHI) is involved. Electronic execution under the ESIGN Act and state e-signature laws is generally acceptable when parties consent and records are retained.

Why a clear written agreement matters for occupational therapy services

A formal Occupational Therapist Agreement reduces disputes, supports billing and reimbursement, ensures HIPAA and licensing compliance, and clarifies professional liability and client expectations.

Why a clear written agreement matters for occupational therapy services

Who commonly completes an Occupational Therapist Agreement

Occupational therapists and organizations use this agreement to document service terms, billing, and compliance before care begins.

  • Independent practitioners and contractors providing outpatient or home-based therapy services to private clients, insurers, or agencies.
  • Healthcare employers and clinics that hire or contract OTs and need consistent scope, credentialing, and HIPAA language.
  • School districts and educational programs that engage OTs for IEP-related services and require FERPA- and HIPAA-aware clauses.

Use the agreement whenever clinical services, reimbursement, or data sharing obligations require a written record of responsibilities.

Core provisions to include in a professional Occupational Therapist Agreement

A robust agreement groups legal, clinical, and administrative terms so each party understands obligations, risk allocation, and compliance requirements.

Parties & Scope

Identify the contracting parties, client identity, and a clear statement of the services to be provided, including settings and limits.

Services & Schedule

Define assessment, treatment, follow-up, frequency, expected duration, and documentation standards for progress notes and discharge summaries.

Compensation & Billing

Specify rates, billing schedule, payer responsibility, invoice timing, fee adjustments, and who submits claims to insurers.

Term & Termination

State the agreement start and end dates, early termination rights, notice periods, and obligations on termination.

Confidentiality & HIPAA

Include PHI protections, reference HIPAA requirements, specify Business Associate Agreement if applicable, and describe permitted disclosures.

Insurance & Liability

Allocate responsibility for malpractice insurance, indemnification, limits on damages, and procedures for claims or disputes.

Step-by-step: preparing and executing an Occupational Therapist Agreement

Follow a consistent workflow to gather credentials, draft terms, obtain signatures, and preserve an audit trail for compliance and billing.

  • 01
    Gather credentials: Collect license, liability insurance, and W-9 if contracting with payers.
  • 02
    Draft terms: Define scope, fees, HIPAA handling, and termination in clear language.
  • 03
    Review for compliance: Confirm HIPAA, licensing, and payer requirements are addressed.
  • 04
    Sign and store: Execute via e-signature or ink, then save encrypted copies and an audit trail.

Setting up a secure online signing workflow for this agreement

Configure authentication, required fields, and retention rules before sending to ensure legal validity and smooth billing.

Field Configuration
Authentication Method Email link with optional SMS code
Template Fields Signature, initials, dates, license number
Consent Disclosure Provide ESIGN consumer disclosure when required
HIPAA BAA Execute BAA if PHI is present

How electronic execution typically flows

Understand the sequence from upload to completed record so each signer knows expectations and the evidence preserved.

  • Upload document: Add the agreement PDF or DOCX to the signing platform.
  • Place fields: Insert signature, date, license, and initial fields in the template.
  • Send to signer: Distribute by email link or secure portal with authentication.
  • Complete and archive: Signed copies and an audit trail are returned and stored securely.

Technical considerations for e-signing and storing the agreement

Use a platform that supports secure signatures, audit trails, and HIPAA controls when PHI is involved.

  • File formats: PDF and DOCX widely supported
  • Integrations: Salesforce, NetSuite, Google Workspace integrations help workflow
  • Authentication: Email, SMS codes, or advanced verification

Confirm storage uses AES-256 encryption and that a BAA is in place for PHI; retain audit logs for compliance.

Timing and key dates to track in the agreement lifecycle

Document critical dates explicitly to avoid billing denials, lapsed credentials, or contested termination claims.

Effective Date:

Date services and obligations begin; use MM/DD/YYYY.

Billing Cycle:

Specify invoicing frequency and payment due days.

Credential Verification:

Verify license and insurance before first billable session.

Termination Notice:

State required days' notice for early termination.

Tax Forms:

Provide W-9 upon request; 1099-NEC reporting triggers Jan 31 deadlines.

Common errors to avoid when preparing this agreement

  • Vague scope of services that leaves session length, objectives, or documentation standards undefined and invites disputes.
  • Omitting license numbers, issuing state, or expiration dates which can block payer credentialing or reimbursement.
  • Skipping a Business Associate Agreement when PHI is shared creates HIPAA compliance exposure and regulatory risk.
  • Using unsigned or improperly witnessed documents for matters that legally require notarization or additional authentication.

Consequences of errors or noncompliance

HIPAA Violations: Civil and criminal penalties and corrective actions under HIPAA and HITECH.
1099 Filing Penalties: $60–$330 per form for late or incorrect filings (IRC §6721)
Backup Withholding: Missing/incorrect TIN can trigger 24% backup withholding.
Unlicensed Practice: State disciplinary action, fines, or license suspension for practicing without valid licensure.
Breach Liability: Contract damages and indemnity obligations for data breaches or service failures.
Delayed Payment: Late invoices or missing documentation may lead to denied reimbursements or claim audits.

How eSignature vendors compare for executing Occupational Therapist Agreements

Common selection criteria include starting price, trial availability, bulk send capability, audit trails, HIPAA compliance, and envelope limits; signNow appears first for reference.

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 Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently asked questions about using and enforcing an Occupational Therapist Agreement

Answers address e-signature validity, PHI handling, signature authority, notarization, amendments, and storage best practices.


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