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Professional Physical Therapist Agreement

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PROFESSIONAL PHYSICAL THERAPIST AGREEMENT

This Professional Physical Therapist Agreement ("Agreement") is entered into as of by and between Physical Therapist Name: , licensed physical therapist, License No. ("Therapist"), and Clinic / Practice Name: , located at ("Clinic"). The Therapist and Clinic are each a "Party" and collectively the "Parties."

RECITALS

WHEREAS, Clinic operates a facility that provides patient care and desires to retain Therapist to provide professional physical therapy services to Clinic's patients under the terms and conditions set forth herein; and

WHEREAS, Therapist is duly licensed and qualified to perform professional physical therapy services and represents that Therapist maintains all necessary credentials, certifications, and insurance required to perform such services; and

WHEREAS, the Parties desire to set forth their respective rights and obligations regarding the provision of such services.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the Parties agree as follows:

1. ENGAGEMENT; SCOPE OF SERVICES

1.1 Engagement. Clinic engages Therapist, and Therapist accepts such engagement, to provide professional physical therapy services (the "Services") to Clinic's patients in accordance with the terms of this Agreement and applicable professional standards.

1.2 Standards of Care. Therapist shall perform the Services in a timely, professional manner consistent with prevailing standards of care, ethics, and all applicable laws and regulations. Therapist shall exercise independent clinical judgment in the treatment of patients.

2. TERM; TERMINATION

2.1 Term. The term of this Agreement shall commence on the effective date set forth above and continue for a period of , unless earlier terminated as provided herein.

2.2 Termination for Convenience. Either Party may terminate this Agreement without cause upon days' prior written notice to the other Party.

2.3 Termination for Cause. Either Party may terminate this Agreement for material breach by the other Party that remains uncured for thirty (30) days after receipt of written notice specifying the breach. Termination shall not relieve either Party of obligations incurred prior to the effective date of termination.

3. COMPENSATION; BILLING; EXPENSES

3.1 Compensation. Clinic shall pay Therapist at the rate of $ per hour for Services rendered, subject to the billing and payment terms set forth herein.

3.2 Billing and Payment. Unless otherwise agreed in writing, Therapist shall submit invoices to Clinic on a basis. Clinic shall pay undisputed amounts within days of receipt of a proper invoice. Disputed amounts shall be subject to good faith resolution.

3.3 Expenses. Clinic shall reimburse Therapist for pre-approved, reasonable, and documented out-of-pocket expenses incurred in connection with the Services within thirty (30) days of receipt of documentation.

4. LICENSURE; CREDENTIALING; INSURANCE

4.1 Licensure and Credentials. Therapist represents and warrants that Therapist holds and will maintain, at Therapist's own cost, all licenses, permits, certifications, registrations, and credentials required to perform the Services. Therapist shall promptly notify Clinic if Therapist's license or certification becomes restricted, suspended or revoked.

Carrier: Policy No.: Limits:

4.2 Evidence of Coverage. Upon request, Therapist shall promptly provide Clinic with certificates of insurance evidencing the required coverage and naming Clinic as an additional insured where appropriate.

5. INDEPENDENT CONTRACTOR; TAXES

5.1 Independent Contractor Status. The Parties acknowledge and agree that Therapist is engaged as an independent contractor and not as an employee, agent, or partner of Clinic. Therapist has exclusive control over the manner and means of performing the Services, subject to the terms of this Agreement.

5.2 Taxes and Benefits. Therapist shall be solely responsible for all federal, state, and local taxes, contributions and other obligations arising from payments made under this Agreement, and shall not be eligible for any benefits provided by Clinic to its employees.

6. CONFIDENTIALITY; RECORDS

6.1 Confidential Information. Therapist shall maintain in strict confidence all confidential information of Clinic and Clinic's patients obtained in the course of performance of Services, and shall not disclose such information except as required for patient care or as required by law. Therapist shall use confidential information only for purposes of providing the Services.

6.2 Patient Records. Clinical records and medical records created in the course of providing Services shall be maintained in accordance with applicable law. Ownership of patient records shall remain with Clinic unless otherwise required by law. Therapist shall cooperate with Clinic in the transfer and retention of patient records upon termination.

7. NON-SOLICITATION

During the term of this Agreement and for a period of twelve (12) months following its termination, Therapist shall not, directly or indirectly, solicit or accept the business of any patient of Clinic for provision of physical therapy services outside the Clinic without the prior written consent of Clinic. This covenant is reasonable and necessary to protect Clinic's legitimate business interests.

8. INDEMNIFICATION; LIMITATION OF LIABILITY

8.1 Indemnification by Therapist. Therapist shall indemnify, defend and hold harmless Clinic and its officers, directors, employees and agents from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of or relating to Therapist's negligence, willful misconduct, breach of this Agreement, or failure to maintain required licensure or insurance.

8.2 Limitation of Liability. Except for liability arising from gross negligence, willful misconduct or indemnification obligations under this Agreement, neither Party shall be liable to the other for consequential, indirect, special or punitive damages.

9. TERMINATION OBLIGATIONS; RETURN OF PROPERTY

Upon expiration or termination of this Agreement for any reason, Therapist shall promptly return to Clinic all Clinic property, records, keys, access credentials and confidential information in Therapist's possession and shall cooperate with Clinic to effect an orderly transition of patient care.

10. NOTICES

All notices required or permitted under this Agreement shall be in writing and shall be deemed given when delivered personally, when sent by certified mail (return receipt requested), or when sent by nationally recognized overnight courier, to the addresses set forth below or to such other address as either Party may designate by notice to the other Party.

11. ASSIGNMENT

Neither Party may assign or delegate its rights or obligations under this Agreement without the prior written consent of the other Party, except that Clinic may assign this Agreement in connection with a sale of substantially all of Clinic's assets or a corporate reorganization.

12. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to principles of conflicts of law. The Parties agree that any legal action relating to this Agreement shall be brought in the state or federal courts located in the appropriate jurisdiction, and the Parties submit to the exclusive jurisdiction and venue of those courts.

13. ENTIRE AGREEMENT; AMENDMENTS; WAIVER

This Agreement constitutes the entire agreement between the Parties relating to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings and representations. Any amendment or modification to this Agreement shall be in writing and signed by both Parties. The waiver of any breach or default under this Agreement shall not constitute a waiver of any subsequent breach or default.

14. SEVERABILITY; COUNTERPARTS

If any provision of this Agreement is held to be invalid or unenforceable, such provision shall be reformed only to the extent necessary to make it enforceable, and the remaining provisions shall remain in full force and effect. This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument.

15. MISCELLANEOUS

The headings used in this Agreement are for convenience only and shall not affect the interpretation of this Agreement. The Parties acknowledge that each has had the opportunity to consult legal counsel of their choice prior to executing this Agreement, and any rule of construction to the contrary shall not apply.

Physical Therapist:

Printed Name:

By:

Date:

Clinic / Practice:

Printed Name:

By:

Date:

Enter text✕

What the Professional Physical Therapist Agreement Is

A Professional Physical Therapist Agreement is a written contract that sets the terms between a licensed physical therapist and a client, clinic, or contracting organization. It defines scope of services, treatment plans, scheduling expectations, fees, billing and insurance arrangements, confidentiality obligations, consent for treatment, and liability limits. The agreement clarifies responsibilities, payment terms, cancellation policies, and data handling requirements, including any HIPAA-related provisions. It may also specify governing law, termination rights, and procedures for amendments or dispute resolution to reduce misunderstandings and support enforceability.

Why a Clear Agreement Matters

Using a Professional Physical Therapist Agreement establishes clear expectations, reduces billing and consent disputes, documents informed consent and HIPAA obligations, and creates enforceable terms for scope, payment, and termination. It protects both practitioner and patient by formalizing responsibilities and risk allocation.

Why a Clear Agreement Matters

Who Typically Uses This Agreement

Licensed therapists, outpatient clinics, hospital therapy departments, rehabilitation centers, and independent contractors use the Professional Physical Therapist Agreement.

  • Independent physical therapists contracting with clinics or agencies for on-site or telehealth services.
  • Outpatient clinics documenting standard care, fees, cancellations, and third-party insurance billing protocols.
  • Hospitals and rehab centers onboarding per-diem therapists and managing liability and documentation.

Use this agreement when engaging patients for regular therapy services, contract placements, or third-party billing arrangements.

Primary Roles That Interact with the Agreement

Clinic Administrator

Oversees adoption and enforcement of patient agreements, confirms therapist licensure and malpractice insurance, attaches HIPAA addenda, and coordinates billing and documentation. The administrator tracks renewals, ensures versions are current, and maintains executed copies for compliance and audit readiness.

Independent Therapist

Signs as service provider or contractor, documents scope, fees, cancellation policies, and confidentiality; must retain proof of consent and copies of signed agreements. Independent practitioners should verify governing law and obtain client signatures before starting treatment.

Security and Compliance Essentials

Data Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
HIPAA Support: BAA available for covered entities
Audit Trail: Detailed timestamps, IP, and action log
Certifications: SOC 2 Type II; ISO 27001; PCI DSS
Electronic Signature: ESIGN and UETA compliant
Accessibility: WCAG 2.0 Level AA support

Key Risks and Penalties to Be Aware Of

1099 Penalties: $60–$330 per form; higher for intentional
I-9 Violations: $281–$2,789 per violation
HIPAA Breach Risk: Civil penalties and corrective action
Licensure Issues: Unlicensed practice risks sanctions
Contract Disputes: Ambiguous terms invite litigation
Data Integrity: Missing retention may undermine defense

Common Preparation Pitfalls

  • Failing to include clear payment and cancellation terms leads to billing disputes and unpaid invoices, especially for multi-visit treatment plans.
  • Using vague scope language or outdated treatment modalities can create liability if care falls outside agreed services or licensure scope.
  • Omitting HIPAA authorizations or failing to attach a BAA when required increases regulatory exposure and patient privacy risk.
  • Not documenting telehealth consent and technology limitations may invalidate remote sessions or create reimbursement issues with insurers.

Step-by-Step: Completing the Agreement

Follow these steps to complete, review, and execute the Professional Physical Therapist Agreement correctly and ensure compliance.

  • 01
    Prepare: Confirm parties, licensure, insurance, and effective date.
  • 02
    Customize: Specify scope, fees, cancellations, and governing law.
  • 03
    Attach: Include HIPAA addenda and insurance authorizations as needed.
  • 04
    Sign: Obtain signatures, dates, and witness/notary where required.

How the Signing and Routing Process Works

Typical routing for the agreement covers creation, internal review, client signing, and secure storage with audit trails.

  • Upload: Add finalized PDF or DOCX
  • Place Fields: Insert signature, date, and initial fields
  • Send: Email link or request in-platform signing
  • Archive: Save signed PDF with audit certificate

Core Components to Include in the Agreement

Core sections and optional clauses commonly included in a Professional Physical Therapist Agreement help define service delivery, compliance, and risk allocation.

Scope of Services

Describe assessment, therapy modalities, frequency, maximum sessions, goals, and any exclusions. Specify whether telehealth is permitted, and list responsibilities for home exercise programs, equipment, and progress reporting.

Fees & Billing

State fee schedule, billing party, accepted payment methods, insurance billing responsibilities, co-pay and deductible expectations, cancellation and late fee policies, and timing for invoicing and collections.

Consent & Privacy

Document informed consent for treatment, capture privacy notices, include HIPAA authorization if PHI is shared, and describe data handling, storage, and patient rights to access records.

Liability & Indemnity

Limit liability where allowed by law, disclose malpractice insurance coverage, clarify indemnification obligations for third-party claims, and address limits on consequential damages to the extent permitted.

Termination

Detail termination for convenience, for cause, notice periods, refunds or pro-rated charges, and obligations that survive termination such as confidentiality and payment.

Governing Law

Specify the governing state law and forum for disputes; note that ESIGN and UETA affect electronic execution and choice-of-law may change enforcement outcomes.

Practical Tips for a Clear Agreement

Follow these practical tips to reduce dispute risk and streamline administration of the agreement effectively.

Use plain, specific language
Write clear, unambiguous provisions for services and fees; avoid legalese. Define measurable objectives and timelines. Specificity reduces interpretation disputes and supports enforceability in court or arbitration.
Attach HIPAA and payment addenda
Include a HIPAA Business Associate Agreement when PHI is processed by vendors and specify payer responsibilities for patient co-pays and denied claims to avoid billing disputes.
Confirm licensure and insurance
Verify therapist state license and professional liability coverage before signing. Include insurance limits and certificate requirements to mitigate malpractice exposure and claims disputes.
Use electronic signatures with audit trails
When e-signing, record intent and consent, use authenticated signer identity, and retain a tamper-evident record to meet ESIGN/UETA legal validity requirements.

Key Milestones from Draft to Archive

Key milestones from contract preparation through execution and post-termination obligations define responsibilities and compliance timelines.

01

Draft Complete

All terms drafted and reviewed by stakeholders.

02

Approvals Secured

Internal approvals and payer checks completed.

03

Signed and Dated

Signatures obtained; date fields completed.

04

Store & Retain

Store executed copy; apply retention schedule.

Relevant Deadlines and Reporting Timeframes

Deadlines and timeframes relevant to tax reporting, record retention, and regulatory reporting obligations arising from the agreement.

Provide W-9 on Request:

Supply a completed W-9 to payers when requested.

1099 Reporting:

Payers file 1099-NEC when contractor payments meet thresholds.

I-9 Retention:

Keep I-9s per federal requirements after hire.

HIPAA Retention:

Retain HIPAA-related records for six years (45 CFR §164.530(j)).

Contract Retention:

Keep executed agreements for at least three years post-termination.

Recommended Digital Workflow Settings

Recommended digital workflow settings for online completion, signing, audit trails, and secure storage of the agreement.

Workflow Field Description and Configuration Recommended setting or value for each field
Signer Authentication Method and Strength Email + SMS code; upgrade to KBA if required
Form Field Types and Conditional Behavior Signature, initials, date, checkbox, conditional fields
Audit Trail Settings and Retention Capture IP, timestamp, email, and action history
Storage and Export Format Settings Save PDF/A with embedded audit certificate

Platform and Integration Considerations

Platform integrations and file formats affect how you share and sign Professional Physical Therapist Agreements.

  • File Types: PDF, DOCX, and editable templates
  • Integrations: Works with Salesforce, NetSuite, Google Workspace
  • Authentication: Email, SMS, SSO options available

eSignature Pricing and Feature Comparison

Compare core pricing and feature availability across common eSignature vendors used for Professional Physical Therapist Agreements.

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 Yes, 7-day trial No No Yes, limited Yes, limited
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies Varies Varies

Frequently Asked Questions

Answers to common questions about completing, signing, and enforcing the Professional Physical Therapist Agreement electronically.


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