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Appendix 12A

Employee Contract

Active clinic: [Company]

This Employment Agreement is entered into between the [Company], incorporated under the laws of the State of Florida (the Agency), and the named employee. Review the terms below before signing.

Agreement Parties and Effective Date

Recitals

The Employee is engaged to provide the services described below. The Employee represents that they have complied with all federal, State of Florida, and local laws regarding business permits, licenses, reporting requirements, tax withholding requirements, and other legal requirements that may be required to perform the Scope of Work under this Agreement. The Agency desires to engage the Employee to perform the tasks set forth, and the Employee agrees to act and perform on the terms and conditions set forth in this Agreement.

Employee Representation

The Employee shall, within the Scope of Work, retain discretion in the manner and means of carrying out activities and responsibilities under this Agreement. This Agreement does not constitute a partnership or joint venture, and the Agency shall not be held liable for obligations incurred by the Employee unless specifically authorized in writing. The Employee shall not act as an agent or representative of the Agency, nor bind the Agency in any manner unless specifically authorized in writing.

Responsibilities, Duties, and Scope of Work

The Employee will be subject to a probationary period of three months from the date of commencement. During the probationary period, the Agency will assess job performance in accordance with the service description and may decide regarding continued employment, as permitted by law.

Compensation is payable every two weeks while this Agreement is in force. The Agency is entitled to deduct any applicable withholdings and remittances as required by law. Any additional remuneration in the form of bonuses or incentive pay rests in the sole discretion of the Agency, and the Employee will not earn or accrue any right to incentive remuneration solely by reason of employment.

Services are provided on an as-needed or per-visit basis within the limits of professional licensing and consistent with the treatment plan or authorized itinerary ordered by the physician for each client. Once an assignment is notified, the Employee is required to provide the Agency with a minimum of four hours notice if unable to fulfill the assignment.

The Agency will initiate payment only upon receipt of all relevant documents, notes, or evidence pertaining to the visits and services. The Employee must furnish the Agency with documented proof of all licenses, certifications, physician examinations, and necessary federal, state, and local documents before the Agency assigns work. The Employee bears full responsibility for remitting estimated taxes, maintaining auto insurance, and obtaining any necessary professional liability insurance.

The Agency reserves the right to impose sanctions for: gross or repeated negligence, incompetence, misconduct, or malpractice in professional work; record-keeping or data collection that deviates significantly from the customary standard of practice or involves deceptive alteration of records; or unauthorized disclosure of confidential information. Instances of gross or repeated negligence will be reported to the appropriate federal or state agency and any relevant licensing or certification board.

The Employee must maintain a written daily summary of client visits and services provided. Each client or authorized household member must sign the daily summary to confirm that services were provided on the specified date. Additional quality assurance measures may be implemented by AHCA, CMS, or the Agency, including telephone verification or other verification methods. Incomplete or inaccurate documentation will result in return of the submission and a delay in payment processing.

The Agency does not guarantee the assignment of any client to the Employee. Allocation of clients is influenced by factors such as geographic location, skill level and qualifications, diagnosis, complexity of care, and other relevant criteria. The Employee is required to maintain professional liability insurance coverage at their own expense.

Documents, Records, and Confidentiality

All documents, records, and books related to the Scope of Work shall be maintained by the Employee at the Employee's principal place of business and remain open to inspection by the Agency during regular business hours. Confidential Information includes data exclusive to the Agency, its subscribers, licensors, licensees, vendors, or partners, that is not commonly known. The Employee commits to maintaining the confidentiality of all medical records and other client-related information consistent with HIPAA and applicable Florida and federal laws.

Work Schedule, Equipment, and Supplies

The Employee shall not be required to follow or establish a regular or daily work schedule. The Employee shall supply all necessary equipment, materials, and supplies needed to complete the Scope of Work and shall not rely solely on the equipment or offices of the Agency.

Conflicts of Interest and Non-Hire

The Employee affirms that this engagement does not infringe upon any agreement with a third party. The Employee may provide services to other entities while engaged with the Agency. The Employee is prohibited from soliciting or hiring any employee, consultant, or contractor of the Agency for one year following termination, either directly or indirectly.

Non-Disclosure, Non-Solicitation, and Non-Compete

The Employee will not bring or use proprietary or confidential information of any other organization in the performance of duties. Throughout the term of this Agreement and for a period immediately following termination, the Employee shall not solicit any client or customer of the Agency for the Employee's benefit or the benefit of any other party. The Employee agrees not to participate in any activity competitive with the Agency during the relationship and for a period of one year after termination.

Term and Termination

This Agreement may be terminated at the conclusion of the Scope of Work or earlier for reasonable cause by either party. The Agency may terminate for cause if the Employee commits a breach and fails to cure within ten business days of notice from the Agency, or within such longer period as is reasonably necessary to accomplish the cure pursuant to a written plan acceptable to the Agency. The Agency may terminate for convenience upon written notice no fewer than 21 business days before the effective termination date.

Professional Conduct and Licensing

The Employee shall treat all Agency staff, clients, and partners with respect, comply with all laws governing the profession, and maintain all licensing required to perform the Scope of Work. The Employee shall promptly provide proof of licensing, general liability insurance upon request of the Agency, and workers compensation coverage where required by law.

Mediation, Arbitration, and Remedies

Disputes arising under this Agreement shall first be submitted to mediation, and if unresolved, to binding arbitration governed by the rules of the American Arbitration Association for Commercial Disputes. The Employee acknowledges that breach of the protective provisions would cause irreparable harm to the Agency and that the Agency shall be entitled to injunctive relief in addition to other remedies. The Employee shall indemnify and hold harmless the Agency from damages, expenses, or liabilities arising from negligence, misconduct, or breach by the Employee.

Entire Agreement and Governing Law

This Agreement constitutes the entire agreement between the parties regarding its subject matter and supersedes all prior or contemporaneous agreements, except for separately signed Confidentiality, Trade Secret, Non-Compete, or Non-Disclosure Agreements. Any modification must be in writing and signed by all parties. This Agreement is governed by the laws of the State of Florida.

Signatures

The undersigned have read, understand, and accept this Agreement and agree to all its terms, conditions, and policies.

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