Rehabilitation Services Annexes

REHABILITATION SERVICES ANNEXES

This Rehabilitation Services Annexes document supplements and is incorporated into the General Business Agreement executed between the parties identified below. The provisions set forth in this Annex govern the delivery, scope, payment, confidentiality and administration of rehabilitation services to be provided by the Service Provider to the Client under the Agreement.

Parties

Client Name:   Client Contact:

Service Provider Name:   Provider Contact:

WHEREAS

WHEREAS, the Client requires specialized rehabilitation services to support client recovery, functional independence, or ongoing habilitation; and

WHEREAS, the Service Provider represents that it is qualified and appropriately licensed, certified, and insured to furnish such rehabilitation services in accordance with applicable professional standards and law; and

WHEREAS, the parties wish to set forth the specific services, deliverables, payment terms, confidentiality obligations and performance expectations applicable to the rehabilitation services;

Scope of Work

Specific modalities included (check all applicable):
Physical therapy   Occupational therapy   Speech therapy   Counseling / Behavioral therapy
Home modifications / accessibility   Assistive devices / equipment   Other (explain)

Payment Terms

Standard Rate per Unit (hour/session): $   Billing Unit:

Invoicing Frequency:   Payment Due (days from invoice):

Late Payment Fee: Interest at   or fixed fee:

Term and Termination

Effective Date:   Expiration Date:

Either party may terminate this Annex for convenience upon  days' prior written notice. Termination for cause is permitted where a party materially breaches a material obligation under this Annex and the breaching party fails to cure within  days after written notice.

Confidentiality

Each party acknowledges that in performing the services, it may receive Confidential Information of the other party. "Confidential Information" includes client medical records, treatment plans, proprietary protocols, and any non-public business or personal information disclosed in connection with services. The receiving party shall: (a) use Confidential Information solely to perform obligations under this Annex; (b) restrict access to those employees, contractors or agents with a demonstrable need to know; and (c) not disclose Confidential Information to any third party without the disclosing party's prior written consent, except as required by law or professional regulation. These confidentiality obligations survive termination of this Annex for a period of three (3) years.

Insurance, Compliance and Personnel

The Service Provider shall maintain professional liability insurance and workers' compensation as required by applicable law and shall ensure that personnel delivering services are properly licensed, trained and credentialed. The Service Provider shall comply with all applicable laws, regulations and professional standards in the provision of services.

Notices

Governing Law; Entire Agreement

This Annex shall be governed by and construed in accordance with the laws of the jurisdiction specified in the underlying General Business Agreement. This Annex, together with the General Business Agreement and any incorporated documents, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral, relating to such subject matter. Any amendment to this Annex must be in writing and signed by authorized representatives of both parties.

Indemnification

Each party shall indemnify, defend and hold harmless the other party from and against any third-party claims, liabilities, losses, costs and expenses (including reasonable attorneys' fees) arising out of the indemnifying party's negligence, willful misconduct, breach of this Annex, or failure to comply with applicable laws in connection with the performance of services, except to the extent caused by the indemnitee's own negligence or willful misconduct.

Recordkeeping and Access

The Service Provider shall maintain contemporaneous records of services delivered, charges, consents and treatment plans for a minimum period required by law. The Client or the Client's authorized representative may request access to records consistent with applicable law and professional standards; the Service Provider shall provide such access in a timely manner and subject to appropriate safeguards for confidentiality.

Dispute Resolution

The parties shall seek in good faith to resolve disputes arising under this Annex through negotiation between senior representatives. If unresolved within thirty (30) days, disputes may be submitted to mediation or other agreed-upon alternative dispute resolution before initiation of litigation, unless otherwise required by the General Business Agreement.

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