Outpatient Therapy Agreement Sample Contracts

Confidential portions of this Exhibit, denoted by bracketed asterisks, have been omitted and filed separately with the Securities and Exchange Commission in reliance on Rule 24b-2 of the Securities Exchange Act of 1934. NxStage Medical, Inc. Chronic...
Outpatient Therapy Agreement • October 1st, 2014 • NxStage Medical, Inc. • Electromedical & electrotherapeutic apparatus • Alaska

The following general terms and conditions apply to the purchase of the NxStage System One (“System”), consisting of either a Cycler, Warmer and Stand, or a Cycler and PureFlow SL (Cabinet and Control Unit), as the case may be, System cartridges and fluids (“Supplies”), and related products and services for use in chronic outpatient therapy (“Related Products”). The System, Supplies and Related Products sold hereunder are referred to collectively as “Products”.

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OUTPATIENT THERAPY AGREEMENT
Outpatient Therapy Agreement • November 16th, 2022

Welcome to our practice. This document contains important information about our professional services and business policies. We’ve tried to be thorough in discussing different questions and issues and have tried to use clear language instead of legal terms. The Agreement also contains information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that we provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment, and health care operations. The Notice, which has been offered to you, explains HIPAA and its application to your PHI in greater detail. The law requires that we obtain your signature acknowledging that we have provided you with this information at or before the end of our

NxStage Medical, Inc. Chronic Outpatient Therapy Agreement
Outpatient Therapy Agreement • August 15th, 2014 • NxStage Medical, Inc. • Electromedical & electrotherapeutic apparatus • Alaska
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