Are electronic signatures legally binding?

Yes. Electronic signatures are generally enforceable under the ESIGN Act and state UETA laws when intent, consent, attribution, and retention criteria are satisfied; exceptions exist for certain documents such as wills and some court filings.

Can HIPAA-related clauses be signed electronically?

Yes, provided the electronic process meets HIPAA confidentiality requirements and a Business Associate Agreement is in place when using third-party signing platforms that handle protected health information.

Is notarization required to record the instrument?

Most counties require a notarized acknowledgement for deeds or lease memoranda; remote online notarization rules differ by state, so confirm with the county recorder or state notary authority before relying on RON.

How do I correct a signed agreement?

Post-signature amendments should be made via a written amendment signed by all parties or by executing a replacement agreement; unilateral edits to executed PDFs can void signature validity.

What authentication level should I use?

Choose authentication based on risk: email-only for low-risk transactions, SMS or KBA for moderate risk, and stronger multi-factor or identity-proofing for agreements affecting patient data or high-value property interests.

How should we store executed copies?

Archive final signed PDFs with embedded audit trails, store backups encrypted at rest, and retain copies according to regulatory retention schedules applicable to tax and healthcare records.

Electronic Signature
Templates
Real estate
Real Estate Medical Arts Agreement

Real Estate Medical Arts Agreement

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

REAL ESTATE MEDICAL ARTS AGREEMENT

This Real Estate Medical Arts Agreement ("Agreement") is made and entered into by and between the parties identified below for the leasing and operation of medical office space under the terms and conditions set forth herein.

PARTIES

Lessor / Landlord Landlord Contact Address Lessor Phone / Email Lessee / Tenant Tenant Contact Address Tenant Phone / Email

PROPERTY

Property Address:

Parcel / APN Number:

Legal Description

LEASE TERM & POSSESSION

Lease Commencement Date: Lease Expiration Date:

Possession / Delivery of Premises:

FINANCIAL TERMS

Monthly Base Rent Security Deposit

Rent Due Day of Month: Grace Period (days):

Late Fee / Interest Tenant Improvement Allowance (if any)

PERMITTED USE; MEDICAL SPECIALTY

Permitted Use: Medical arts office for the practice of . Use shall be limited to activities consistent with federal, state, and local health regulations, licensing, and applicable privacy laws.

Tenant shall not use or permit the Premises to be used for any practice, procedure or storage of materials that would require structural changes or create biohazardous conditions without prior written consent of Landlord and without provision of required permits, containment, and waste disposal protocols.

UTILITIES, SERVICES & COMMON AREAS

Utilities: Tenant shall be responsible for payment of utilities serving the Premises as follows:

Common Area Maintenance (CAM) Charges: Tenant shall pay CAM charges in the amount or proportion described:

MAINTENANCE, REPAIRS & ALTERATIONS

Landlord Maintenance Obligations: Landlord shall maintain structural components, roof, foundation, and building mechanical systems serving multiple tenants unless damage is caused by Tenant's negligence. Tenant Maintenance Obligations: Tenant shall maintain interior finishes, medical equipment, and systems serving only the Premises.

Alterations and Improvements

INSURANCE & INDEMNITY

Tenant shall maintain commercial general liability insurance with limits not less than and shall carry professional liability insurance when required by Tenant's medical practice. Tenant shall list Landlord as additional insured to the extent of Landlord's interest in the Premises.

Indemnification: Tenant shall indemnify, defend and hold Landlord harmless from and against all claims, liabilities, losses, damages, costs and expenses arising out of Tenant's use of the Premises, including claims arising from professional services provided, except to the extent caused by Landlord's gross negligence or willful misconduct.

HAZARDOUS MATERIALS & MEDICAL WASTE

Tenant shall be solely responsible for the storage, handling, transport and disposal of all medical, biological and hazardous waste generated on the Premises in compliance with applicable law. Tenant shall not store, treat or dispose of hazardous materials on the Premises except those customary for normal medical office operations and then only in accordance with all applicable laws and regulations.

DISCLOSURES

Lead-Based Paint (if applicable): Yes No

Mold or Water Intrusion History: Yes No

Prior Structural or Fire Damage: Yes No

If any disclosure is Yes, provide details

DEFAULT, REMEDIES & TERMINATION

Default: Tenant is in default upon failure to pay rent when due, breach of material covenant, abandonment, or failure to cure other breaches within the applicable cure period. Landlord's Remedies: On default, Landlord may pursue any remedy available at law or in equity including termination of the Lease, reentry, damages and recovery of costs and attorneys' fees.

Cure Period for Nonpayment:

ASSIGNMENT & SUBLEASE

Tenant shall not assign this Agreement or sublease the Premises without Landlord's prior written consent, which shall not be unreasonably withheld for assignments or subleases compatible with medical uses approved herein. Any permitted assignment or sublease shall not relieve Tenant of its obligations under this Agreement unless Landlord expressly releases Tenant in writing.

DEFAULT INSURANCE & CASUALTY; CONDEMNATION

Casualty: If the Premises are damaged by fire or other casualty, Landlord shall restore the Premises within a reasonable period provided the damage does not render the Premises unsuitable for Tenant's permitted use. If restoration cannot be completed within Tenant may elect to terminate.

Condemnation: In the event of a taking or acquisition of the Premises or substantial portion thereof, this Agreement shall terminate as to the portion taken and any award for the taking belonging to Tenant shall be Tenant's unless otherwise agreed.

COMPLIANCE; LICENSES; REQUIRED PERMITS

Tenant shall obtain and maintain all licenses, permits and approvals necessary for Tenant's operations, including but not limited to professional licensing and health permits. Tenant shall comply with the Americans with Disabilities Act and all accessibility requirements and shall not modify the Premises in a manner that renders them noncompliant without Landlord's prior written consent.

NOTICES

Notices to Landlord shall be sent to:

Notices to Tenant shall be sent to:

MISCELLANEOUS PROVISIONS

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the state in which the Premises are located.

Entire Agreement: This Agreement (including any exhibits and attachments) constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings.

Additional Terms / Special Provisions

CERTIFICATIONS

Each party certifies that the signatory below is authorized to execute this Agreement on behalf of the party, that the information provided herein is true and correct, and that, upon execution, this Agreement will be binding and enforceable in accordance with its terms.

Landlord / Lessor:

By:

Date:

Tenant / Lessee:

By:

Date:

What the Real Estate Medical Arts Agreement Is

A Real Estate Medical Arts Agreement is a contract that governs the leasing, sale, or development of property used for medical or clinical services, combining standard real estate terms with healthcare-specific provisions such as patient privacy, access requirements, and permitted uses. It defines parties, permitted improvements, utilities, insurance, indemnity, compliance with healthcare regulations, and allocation of maintenance, and it allocates operational responsibilities between landlord and tenant or buyer and seller. The agreement ensures both property rights and clinical operational needs are addressed in one document.

Why this Agreement Matters for Healthcare Real Estate

Combines real property rules with healthcare operational needs so clinical workflows, HIPAA obligations, and facility requirements are contractually aligned. Establishes risk allocation, tenant improvements, and compliance obligations to reduce regulatory and operational friction during occupancy or transfer.

Who typically prepares and signs this agreement

Multiple stakeholders participate: landlords, medical practices, hospital affiliates, practice managers, and counsel coordinate terms to reflect clinical and property requirements.

Healthcare practice executives and managers responsible for clinical operations and regulatory compliance who need clear space-use and privacy terms.
Commercial landlords and property managers who must document permitted medical uses, tenant improvements, and maintenance responsibilities.
In-house or outside attorneys who draft lease or sale terms and ensure alignment with state real estate law and healthcare regulations.

Final execution often requires signatories authorized by each party plus counsel approval; notarization or witness steps vary by state and by the type of instrument being recorded.

Primary signers and stakeholders

Clinic Director

Clinic Directors or Practice Owners sign for the tenant party and verify clinical use terms, space requirements, and compliance obligations such as HIPAA safeguards.

Property Manager

Property managers or authorized leasing agents sign on behalf of the landlord and confirm building standards, maintenance obligations, and permitted improvements.

Core sections to include in a professional agreement

A complete Real Estate Medical Arts Agreement addresses standard real estate clauses plus healthcare-specific elements. Each section should be clear, measurable, and tailored to the clinical use to reduce ambiguity and downstream disputes.

Premises

Precise legal description and suite boundaries, square footage, common area allocations, and any licensed spaces where medical services will be delivered and regulated.

Permitted Use

Defines allowed clinical activities, restricted procedures, hours of operation, and conditions for additional services such as imaging, lab draws, or overnight stays.

Improvements

Tenant improvement allowance, approval processes for clinical build-outs, compliance with building and life-safety codes, and ownership of installed equipment.

Compliance

Obligations to comply with HIPAA, OSHA, local healthcare facility regulations, and federal/state licensing; includes audit and corrective action rights.

Insurance

Insurance types, limits, and naming of additional insureds, including professional liability, general liability, property, and workers' compensation requirements.

Termination

Early termination rights for regulatory suspension, breach, or insolvency; transition obligations to protect patient records and continuity of care.

Essential information to record

Party Names: Full legal names of all parties.

Property ID: Street address and legal description.

Effective Date: MM/DD/YYYY format.

Term Length: Months or years stated.

Consideration: Rent or purchase price.

Signatures: Dated, printed names included.

Step-by-step: completing and executing the agreement

Follow these sequential steps to prepare, review, sign, and record the Real Estate Medical Arts Agreement while preserving compliance and enforceability.

01

Drafting: Assemble property, clinical use, and regulatory terms with counsel review.
02

Internal Approval: Obtain sign-off from practice leadership and facilities or compliance teams.
03

Execution: All authorized signers sign, date, and notarize if required.
04

Recording: Record deed or lease memorandum with county recorder where applicable.

How to configure an online signing workflow

Use these settings when preparing an electronic signing workflow to ensure correct routing, authentication, and document integrity.

Field	Configuration
Signer Order	Define sequential or parallel signing as required.
Authentication Method	Use email link, SMS code, or stronger KBA for higher assurance.
Conditional Fields	Show or hide clinical addenda based on checkbox selections.
Audit Trail	Enable full event logging and completion certificate.

Typical routing and delivery process

A standard online workflow moves the document from preparer to signer to archive, capturing identity, timestamps, and audit data at each step.

Upload Document: Prepare final PDF or DOCX for signing.
Place Fields: Add signature, date, and initial fields for each party.
Send to Signers: Route via email or generate secure signing link.
Archive Copy: Store executed PDF plus audit trail securely.

Digital signing and eSubmission considerations

Ensure the chosen eSignature platform supports HIPAA protections, strong authentication, and produces a verifiable audit trail before transmitting clinical real estate documents.

Authentication: Email, SMS, or knowledge-based options.
Document formats: PDF and DOCX supported for records.
Integrations: Connectors for Google Workspace or NetSuite.

Use platforms that support TLS and AES encryption, role-based access controls, and retention policies that meet clinical and financial recordkeeping requirements.

Common mistakes to avoid

Using informal party names instead of exact legal entity names, which can block recording or trigger tax withholding.
Failing to include HIPAA or patient-data language when clinical services will occur on-site, increasing compliance risk.
Omitting landlord consent for tenant improvements that affect clinical workflows or life-safety systems, causing costly corrective work.
Relying on weak signer authentication for documents that control patient information or clinical operations, increasing repudiation risk.

Key risks and potential penalties

Tax Penalties: Incorrect filings can trigger IRC §6721 fines.

I-9 Violations: Employment paperwork errors may incur DHS fines.

HIPAA Violations: Breach of PHI can lead to civil penalties.

Recording Rejection: Improperly formatted deeds may be refused.

Contract Disputes: Ambiguity can cause litigation or injunctions.

Non-enforceable Signatures: Lack of intent or consent can void terms.

Supporting documents to attach

Attach these documents to ensure the agreement is complete, enforceable, and ready for recording or clinical operations.

Site Plans

Floor plans, egress diagrams, and ADA compliance checks that describe clinical flow and emergency access requirements tied to the leased premises.

Certificate of Insurance

Current policies and endorsements naming additional insured parties and confirming coverage limits required by the lease.

Tenant Improvement Specs

Architectural drawings, build-out timelines, and approval conditions that allocate responsibilities and finishing standards.

License Evidence

Copies of applicable medical licenses or registrations demonstrating the tenant’s authority to provide clinical services at the location.

Real-world examples of this agreement in practice

These case summaries show how parties used the agreement to balance property rights with clinical needs and regulatory compliance.

Martin Properties

A small medical group needed rapid execution and compliance assurances.

Bulk signing and mobile execution shortened turnaround.
Resulting lease included a HIPAA addendum and tenant improvement allowance, enabling clinical build-out without delaying the opening of a new clinic.

Fertility Centers of Illinois

A regional center required clear IP and equipment provisions.

Contract added customized equipment ownership clauses.
The agreement prevented post-termination disputes over diagnostic equipment and ensured continuity of patient records during transitions between facilities.

Important timelines and deadlines to track

Key dates affect enforceability, tax reporting, recordation, and operational readiness; calendar these deadlines during negotiation and execution.

Effective Date:

Date parties specify; obligations begin on this date.

Recordation Window:

Record lease memorandum or deed promptly to preserve priorities.

Tax Reporting:

Provide required W-9 information upon request to avoid backup withholding.

Insurance Proof:

Deliver certificates before occupancy per lease schedule.

Build-out Deadlines:

Monitor milestone dates for tenant improvements and final inspection.

Key milestones from negotiation to occupancy

Track these sequential milestones to keep the project on schedule and to coordinate clinical readiness with property deliverables.

01

Letter of Intent

Nonbinding terms agreed to guide formal drafting and due diligence.

02

Lease Execution

Legally binding signatures completed by authorized representatives.

03

Tenant Improvements Complete

Final inspections passed and occupancy certificate obtained.

04

Operational Go-Live

Clinical services commence once licenses and insurance are in place.

eSignature vendor comparison for this document

Compare starting pricing and key capabilities relevant to executing clinical real estate agreements; signNow is shown first per table convention.

	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 credit card	No free trial	No free trial	Free trial available	Free trial available
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA available)	Yes	Yes	No	No

Practical tips for accurate completion

Adopt these practices to reduce errors and accelerate execution while protecting clinical operations and regulatory compliance.

Use exact legal names

Confirm entity names via formation documents and use identical spelling across all fields to avoid recording or tax issues.

Include HIPAA language

Add explicit data handling, business associate, and breach-notification clauses when patient information is processed on-site.

Confirm signatory authority

Collect corporate resolutions or power-of-attorney where needed to verify the signer’s legal authority to bind the entity.

Retain audit trails

Preserve eSignature certificates and event logs to demonstrate intent, consent, and attribution if disputes arise.

Frequently asked questions and troubleshooting

Answers to common questions about enforceability, notarization, eSigning, and post-execution changes for Real Estate Medical Arts Agreements.

Need help? Contact support

Are electronic signatures legally binding?
Yes. Electronic signatures are generally enforceable under the ESIGN Act and state UETA laws when intent, consent, attribution, and retention criteria are satisfied; exceptions exist for certain documents such as wills and some court filings.
Can HIPAA-related clauses be signed electronically?
Yes, provided the electronic process meets HIPAA confidentiality requirements and a Business Associate Agreement is in place when using third-party signing platforms that handle protected health information.
Is notarization required to record the instrument?
Most counties require a notarized acknowledgement for deeds or lease memoranda; remote online notarization rules differ by state, so confirm with the county recorder or state notary authority before relying on RON.
How do I correct a signed agreement?
Post-signature amendments should be made via a written amendment signed by all parties or by executing a replacement agreement; unilateral edits to executed PDFs can void signature validity.
What authentication level should I use?
Choose authentication based on risk: email-only for low-risk transactions, SMS or KBA for moderate risk, and stronger multi-factor or identity-proofing for agreements affecting patient data or high-value property interests.
How should we store executed copies?
Archive final signed PDFs with embedded audit trails, store backups encrypted at rest, and retain copies according to regulatory retention schedules applicable to tax and healthcare records.

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