Compensation. Termination (Check one) ☐ After all of the Services are completed. 9. Business Records. INTRODUCTION WHEREAS . Patient Records. We each agree to sign and abide by a HIPAA Business Associates Agreement if required by law. Your association as an independent contractor with the Practice does not entitle you to general access to the patient records of the Practice. An independent contractor agreement details the terms under which the independent contractor is working for the business. If prior to the effective date Employer dies, becomes, disabled (as defined in Employer's major medical insurance policy), retires or withdraws from the practice, Contractor shall have the option to purchase the Practice, exercisable by a writing to Employer or Employer's representation, at its appraised value, excluding good will, as determined by each party selecting an independent appraiser with experience in valuing dental practices in the area of region, which appraisers shall agree upon a third independent appraiser with such experience who shall alone make the appraisal for this purpose and whose selection and determination shall be final. 10. Forming an LLC may be appropriate if you are planning to make a career so to speak out of being an independent contractor. If an employee relationship exists, adjust compensation provided to … An Independent Contractor Agreement is used to formalise an arrangement between a client and a freelance contractor, whereby the contractor will provide specified services for the client. 3. Patient Flow and Management Responsibilities. You will be associated as an independent contractor with the Practice as a ("general dentist") on a ("part/full") time basis commencing on (EFFECTIVE DATE). This letter of agreement includes our entire agreement with respect to your status as an independent . This independent contractor agreement (the “Agreement”) is made and entered into as of [DATE OF AGREEMENT] (the “Effective Date”) between [NAME OF ENTITY] (the “Company”), a [STATE][TYPE OF COMPANY], and [NAME OF CONTRACTOR], a (the “Contractor”) (collectively, the “Parties”). It should also clearly state how the independent contractor is not an employee of the business. Suggest changes by making a copy of this document. There is a lot of misinformation about what is necessary to ensure as an owner you are not deemed to have employed a dentist and then find you are up for Workcover and Superannuation or Unfair dismissal. Learn more. You will maintain memberships in professional societies as appropriate, and attend such professional meetings and continuing dental education programs as may be necessary to maintain your professional knowledge and skills. You will attend general practice meetings at the request of the Practice. The Dental Hygienist further agrees not to claim any benefit or protection under any law 1.3. for the associate to provide services? 1. Your associate as an independent contractor with the Practice requires you to maintain business records, but does not entitle you to general access to the business records of the Practice. You shall have access to the business records of the Practice only to the extent necessary to verify compensation due to you from the Practice should a dispute arise. The Practice will be responsible for paying rent, utilities, provision of adequate dental equipment and office staff support, and one operatory available by schedule. This agreement is signed by the parties and effective on the date first written above. It is your responsibility to develop and secure your patient base. By making this document private, only you will be able to view or sign it. Therefore, Caregiver shall bear all responsibility for the payment of Social Security and Medicare taxes as well as any other withholdings 1. You will be specifically responsible for the direction, hiring and/or termination of the dental assistant assigned or hired by you and in either event compensated by you. Practice shall not exercise any control or direction over the professional aspects of your providing services, which control and direction shall be your sole responsibility, provided, however, that such services are to be rendered in accordance with the provisions of this agreement and the bylaws, rules and regulations, standards, and policies of Practice and any regulatory agency with jurisdiction over matters subject to this agreement. Practice shall not exercise any control or direction over the professional aspects of your providing services, which control and direction shall be your sole responsibility, provided, however, that such services are to be rendered in accordance with the provisions of this agreement and the bylaws, rules and regulations, standards, and policies of Practice and any regulatory agency with jurisdiction over matters subject to this agreement. Client will not require Contractor to rent or purchase any equipment, product, or service as a condition of entering into this Agreement. Indemnification. Independent Contractor agrees that customers of the Company shall include, but are not limited to the following: 12. 10. The dentist argued that the truth of his relationship with the business was employment, notwithstanding that he had entered into a contractor’s agreement with the company. Further, the agreement stated the parties' relationship was terminable on the giving of four weeks' notice. However, whether these people are independent contractors or employees depends on the facts in … If the associate is an employee, the dentist employer will typically provide such things. However, as explained above, the fact that the agreement exists, on its own, is not enough to show that the service provider is an independent contractor. If there is a written agreement between the parties stating that an independent contractor relationship exists, this will help establish the existence of an independent contractor relationship. Terms: Among the included details you can expect to find in the terms of an independent contractor agreement include: the names of both the business and the subcontractor, the work location, the date of the agreement, and the overall job description. By entering into this agreement, you hereby agree to indemnify and hold Employer and the Practice harmless for any malpractice liability resulting from treatment provided by you. DENTIST INDEPENDENT CONTRACTOR AGREEMENT. contractor and supersedes all oral discussions, which we may have had. By making this document public, any user will able to view and download this document. If prior to the effective date Employer shall attempted to sell the Practice to a party other than the Contractor, the Contractor shall have the right of first refusal to purchase the Practice from Employer on identical terms and conditions. If you feel an independent contractor relationship exists, then be sure to maintain accurate records, follow the rules on Form 1099, and have a written agreement with your in dependent contractor. Your associate as an independent contractor with the Practice requires you to maintain business records, but does not entitle you to general access to the business records of the Practice. INDEPENDENT CONTRACTOR AGREEMENT. As an independent contractor, you will be responsible for scheduling and maintaining office hours to treat your patients, as you deem appropriate. Signing with Docracy just got an upgrade — read about our new eversign eSign integration What's changed? contained herein, Contractor shall be an independent contractor of Office and nothing set forth in this Agreement shall, or is intended to, create any employment based on contract or otherwise, and the parties are not, and shall not be deemed to be, partners, joint venturers, lender or borrower of the other. Duties of Contractor. 5. This agreement is signed by the parties and effective on the date first written above. version 6 by BRIAN LEE. Contractor's option to purchase or right of first refusal, as the case may be, shall be exercisable by a written notice specifying Contractor's intent and delivered to Employer representative within 30 days of the event prompting such option or right. 5. Business Expenses. Upon termination, you will vacate the premises and promptly remove all patient records and personal supplies and belongings. This is an example of an agreement between a community health agency and a private allied health service provider. The term of your association shall be for , starting on the Effective Date (the "term"), the association automatically renewable for successive periods equal to the term in length (each a "successive term"), but either you or the Practice shall have the right to terminate your association, for any reason and without liability, upon days prior written ("letter or email") notice to the other. Contractor is an independent contractor, and neither Contractor nor Contractor's employees or contract personnel are, or … To learn more about another important contract for dental practices, you can read shareholder Buy-Sell Agreements for dental companies. Independent Contractor Agreement - Physician By making this document private, only you will be able to view or sign it. The equity purchase shall be undertaken on such other reasonable and customary terms as the parties may mutually agree upon. Association. For an employee, the employer dentist must generally withhold income taxes, withhold and pay social security and Medicare taxes, pay unemployment tax, and afford workers’ compensation benefits. For example, this agreement can be used when a contractor is hired to do repairs or perform renovations at a private residence or business location. By agreeing to become associated with the Practice, you agree to indemnify and hold harmless Employer and the Practice from any personal state or federal tax liabilities you incur. By agreeing to become associated with the Practice, you agree to indemnify and hold harmless Employer and the Practice from any personal state or federal tax liabilities you incur. From a non-tax standpoint, the major issue is vicarious liability, whereby an employer may be liable for the negligent acts of an employee. In making a determination whether an individual is an employee or an independent contractor, governmental agencies will look at factors such as: The Consultant wishes to accept such appointment. You shall have access only to those records of patients whom you treat. by Correct Care Inc. Health Project LLC The Caregiver is acting in their own accord providing a service which recognizes the Caregiver as an Independent Contractor as defined under Federal and State law. That’s not up to an employee or employer. An Independent Contractor Agreement is a written contract that spells out the terms of the working arrangement between a contractor and client, including: A description of the services provided; Terms and length of the project or service; Payment details (including deposits, retainers, and … Association. 8. ARTICLE 1 - INDEPENDENT CONTRACTOR RELATIONSHIP 1.1.The parties specifically agree that the Dental Hygienist is an independent contractor and is not in any manner an employee, joint venturer or partner of the Dentist with regard to the services to be carried out or performed pursuant to this Agreement… Learn more. Compensation. This letter of agreement includes our entire agreement with respect to your status as an independent . Whether an associate dentist is considered an employee or independent contractor could have certain tax and non-tax consequences for the owner of a dental practice. All patient records, histories, charts, and other information regarding patients treated or matters handled by you under this agreement, regardless of whether any of the forgoing are in your possession, shall be your property subject to all applicable federal, state, and local laws, regulations, and ordinances and any applicable code of ethics. Approach A: You will pay the Practice $ ($1) by the (DATE) of each (MONTH) for use of one operatory, equipment, office personnel and supplies. Your association as an independent contractor with the Practice does not entitle you to general access to the patient records of the Practice. As an independent contractor of the Practice, and not an employee, you will be solely responsible for payments of all federal income and self-employment taxes related to income paid to you by the Practice. It is your responsibility to obtain malpractice insurance in the minimum amount of $ ($2) and to provide a copy of this policy to the Practice prior to your commencement. Agreement. Contractor's option to purchase or right of first refusal, as the case may be, shall be exercisable by a written notice specifying Contractor's intent and delivered to Employer representative within 30 days of the event prompting such option or right. At all times, your services so rendered shall comply with (1) all applicable federal, state, and local laws, regulations and ordinances, (2) the professional standards then prevailing in the community, and (3) currently accepted methods, practices, and code of ethics of the American Dental Association. To get free e-signing, version tracking and help others! Nothing on this site shall be considered legal advice and no attorney-client relationship is established.Disclaimer Details. Indemnification. This independent contractor agreement (the “Agreement”) is made and entered into as of [DATE OF AGREEMENT] (the “Effective Date”) between [NAME OF ENTITY] (the “Company”), a [STATE] [TYPE OF COMPANY], and [NAME OF CONTRACTOR], a (the “Contractor”) (collectively, the “Parties”). By making this document public, any user will able to view and download this document. Open legal documents with free e-signing. We each agree to sign and abide by a HIPAA Business Associates Agreement if required by law. Miscellaneous. THIS AGREEMENT executed on this the ___ day of _____, 20 ___, but agreed to be effective from and after _____, 20 ____, by and between _____ (hereinafter “Company”), and _____(hereinafter “Contractor”).. NOW, THEREFORE, FOR AND IN CONSIDERATION of the mutual promises and agreements contained herein, Company hires Contractor, and Contractor agrees … 7. The Parties agree and acknowledge that this Agreement and Independent Contractor’s engagement with Client under this Agreement shall terminate upon the We have many more template about Dental Independent Contractor Agreement Template including template, printable, photos, wallpapers, and more. The essential terms are about the same as between a dentist employment contract and a dentist independent contractor agreement. What’s the risk of hiring an independent contractor? Notice- Independent Contractor shall notify the Company of any changes to its liability or workers compensation insurance. On termination or expiration of this agreement for any reason, you shall be responsible for maintaining and moving your records. This independent contractor agreement (the “Agreement”) is made and entered into as of (the “Effective Date”) between (the “Company”), a , and , a (the “Contractor”) (collectively, the “Parties”). Dentist Independent Contractor Agreement Template. The Contractor's equity interest in such Practice being purchased herein shall be paid for in equal consecutive monthly installments of principal, plus % interest on the remaining unpaid balance, over (years) period, pre-payable without penalty. Indepedent Contractor Dental Associate Agreement. by Bruce Warila, Independent Contractor Agreement Form - Attorney Prepared 4. The equity purchase shall be undertaken on such other reasonable and customary terms as the parties may mutually agree upon. Public 7. contractor and supersedes all oral discussions, which we may have had. Independent Contractor’s engagement with Client under this Agreement shall commence on _____, 20_____. Approach B: You will pay the Practice (%1) % of your gross (collections/production), that is, gross fees billed and (collected/produced) attributable to services which you perform and complete, less (a) any professional or other discounts which you or the Practice grant, and (b) (%2) % of the laboratory charges for you production. Are you sure you want to delete this document? ____________________________ _____________________________. 9. As an independent contractor, you will be solely responsible for all billing for services you render, and for all contractual allowances, free care, discounts, bad debts, collections, and costs related to the foregoing. by BRIAN LEE. The words “employee” and “independent contractor” are legally meaningful concepts that define the relationship in which one individual or entity retains another to perform certain work. Such as pdf, jpg, animated gifs, pic art, logo, black and white, transparent, etc. You shall complete, in a timely manner, all patient records on each patient treated and shall maintain the confidentiality of such records as required by federal, state, and local laws, regulations, and ordinances. You shall complete, in a timely manner, all patient records on each patient treated and shall maintain the confidentiality of such records as required by federal, state, and local laws, regulations, and ordinances. The Consultant is able to provide the service as required by the Company and warrants the he is suitably organised, qualified, financed, equipped and You will attend general practice meetings at the request of the Practice. 2. The fact that the associate agreement declares the associate to be an independent contractor does not make it so! If prior to the effective date Employer dies, becomes, disabled (as defined in Employer's major medical insurance policy), retires or withdraws from the practice, Contractor shall have the option to purchase the Practice, exercisable by a writing to Employer or Employer's representation, at its appraised value, excluding good will, as determined by each party selecting an independent appraiser with experience in valuing dental practices in the area of region, which appraisers shall agree upon a third independent appraiser with such experience who shall alone make the appraisal for this purpose and whose selection and determination shall be final. 2. You shall have access only to those records of patients whom you treat. Independent Contractor agreement for the dental associate. by andrew mcfarlane, Rights and Services Agreement for 360 Music Deal Patient Flow and Management Responsibilities. Independent Contractor Agreement - Physician, Rights and Services Agreement for 360 Music Deal, Independent Contractor Agreement Form - Attorney Prepared. The written agreement had been backdated and stated Dr Li was at all times an independent contractor and not an employee of KC Dental. Approach B: You will pay the Practice % of your gross , that is, gross fees billed and attributable to services which you perform and complete, less (a) any professional or other discounts which you or the Practice grant, and (b) % of the laboratory charges for you production. If prior to the effective date Employer shall attempted to sell the Practice to a party other than the Contractor, the Contractor shall have the right of first refusal to purchase the Practice from Employer on identical terms and conditions. If you are looking for Dental Independent Contractor Agreement Template you have come to the right place. Private. From a tax standpoint, an employer is required to withhold certain taxes. It is your responsibility to develop and secure your patient base. You must require that any insurance carrier provide the Practice at least 15 days prior written notice of any cancellation, termination, modification or amendment. The Department of Labor (DOL) makes that decision on an individual basis. Open legal documents with free e-signing. 1.1.The parties specifically agree that theDental Hygienist is an independent contractor and is not in any manner an employee, joint venturer or partner of the Dentist with regard to the services to be carried out or performed pursuant to this Agreement. Quickly sign this document with anyone, just send them this link. The terms of the purchase shall provide that the Contractor shall be entitled to (%3) %, of the Practice net income, and that the Contractor shall purchase at book value as then accounted for in the financial statements of Practice not including any goodwill, a (%4) % interest in the Practice. DENTIST INDEPENDENT CONTRACTOR AGREEMENT. All patient records, histories, charts, and other information regarding patients treated or matters handled by you under this agreement, regardless of whether any of the forgoing are in your possession, shall be your property subject to all applicable federal, state, and local laws, regulations, and ordinances and any applicable code of ethics. 3. What if the dental temp wants to be an independent contractor? Independent Contractor Status. INDEPENDENT CONTRACTOR AGREEMENT. 11. Stating this exempts the business from any legal obligation to the independent contractor that might be due to an employee. An independent contractor agreement is between a client and a company that makes a promise to produce services in exchange for payment.The client will have no responsibility for employees, subcontractors, or personnel in connection with the services provided. The parties contemplate that Contractor shall enter the Practice as an equity owner, effective upon the termination of this Agreement as of . You shall have access to the business records of the Practice only to the extent necessary to verify compensation due to you from the Practice should a dispute arise. Approach A: You will pay the Practice $ by the of each for use of one operatory, equipment, office personnel and supplies. 2. 1. Contractor may at its discretion engage subcontractors to perform services under thi s Agreement, but Contractor shall remain responsible for proper completion of this Agreement. 1099 Independent Contractor. 1. On termination or expiration of this agreement for any reason, you shall be responsible for maintaining and moving your records. For example, a more independent contractor relationship would allow the dental hygienist to set their own work schedule. Patient Records. As an independent contractor, you will be solely responsible for all billing for services you render, and for all contractual allowances, free care, discounts, bad debts, collections, and costs related to the foregoing. As an independent contractor of the Practice, and not an employee, you will be solely responsible for payments of all federal income and self-employment taxes related to income paid to you by the Practice. On the effective date, Practice and Contractor agree that Contractor shall have the option to acquire capital stock in the Practice on the terms herein provided. Upon termination, you will vacate the premises and promptly remove all patient records and personal supplies and belongings. The Contractor's equity interest in such Practice being purchased herein shall be paid for in equal consecutive monthly installments of principal, plus (%5) % interest on the remaining unpaid balance, over (years) period, pre-payable without penalty. By entering into this agreement, you hereby agree to indemnify and hold Employer and the Practice harmless for any malpractice liability resulting from treatment provided by you. Signing with Docracy just got an upgrade — read about our new eversign eSign integration What's changed? As an independent contractor, you will be responsible for scheduling and maintaining office hours to treat your patients, as you deem appropriate. Option to Enter Practice. You shall be responsible for dental supplies, your own dental instrumentation, your own professional malpractice insurance coverage, your own laboratory billings, and hiring and compensating your chairside assistant. Responsibility for Taxes. The parties contemplate that Contractor shall enter the Practice as an equity owner, effective upon the termination of this Agreement as of (EFFECTIVE DATE1). It is a contract used with private providers involved in service models supported by … 1.2. Public People such as doctors, dentists, veterinarians, lawyers, accountants, contractors, subcontractors, public stenographers, or auctioneers who are in an independent trade, business, or profession in which they offer their services to the general public are generally independent contractors. It would be for a shorter term (e.g. Whether the dentist is an “employee” or an “independent contractor” is a matter of great Nothing on this site shall be considered legal advice and no attorney-client relationship is established.Disclaimer Details. Miscellaneous. Start here to make a copy of this document in your library. Independent Contractor agreement for the dental associate. Independent Contractor Status Contractor is an independent contractor, not Owner's employee. At all times, your services so rendered shall comply with (1) all applicable federal, state, and local laws, regulations and ordinances, (2) the professional standards then prevailing in the community, and (3) currently accepted methods, practices, and code of ethics of the American Dental Association. Contractor's employees or subcontractors are not Owner's employees . The terms of the purchase shall provide that the Contractor shall be entitled to %, of the Practice net income, and that the Contractor shall purchase at book value as then accounted for in the financial statements of Practice not including any goodwill, a % interest in the Practice. If the associate is an independent contractor, they sometimes provide their own tools to … Who will be providing the dental tools, equipment, supplies, etc. 13. 9. Business Records. The Practice will be responsible for paying rent, utilities, provision of adequate dental equipment and office staff support, and one operatory available by schedule. You will be specifically responsible for the direction, hiring and/or termination of the dental assistant assigned or hired by you and in either event compensated by you. The term of your association shall be for (LENGTH OF CONTRACT/MONTHS), starting on the Effective Date (the "term"), the association automatically renewable for successive periods equal to the term in length (each a "successive term"), but either you or the Practice shall have the right to terminate your association, for any reason and without liability, upon (30) days prior written ("letter or email") notice to the other. Whether there are benefits to forming a single member LLC in your situation is probably something you should spend an hour … Option to Enter Practice. This agreement may be amended or assigned by you and the Practice at any time only by an instrument in writing signed by both parties. A dentist was not an employee of the practice where he worked but instead was an independent contractor, the California Court of Appeal held. You will maintain memberships in professional societies as appropriate, and attend such professional meetings and continuing dental education programs as may be necessary to maintain your professional knowledge and skills. Association. You must require that any insurance carrier provide the Practice at least 15 days prior written notice of any cancellation, termination, modification or amendment. 1.1. In these page, we also have variety of images available. You will be associated as an independent contractor with the Practice as a ("general dentist") on a ("part/full") time basis commencing on . 1. by Naitik Patel, Dental Practice Purchase Agreement 11. Indepedent Contractor Dental Associate Agreement General Duties. 6 months, 1 year, etc.) On the effective date, Practice and Contractor agree that Contractor shall have the option to acquire capital stock in the Practice on the terms herein provided. Make a copy and customize. It is your responsibility to obtain malpractice insurance in the minimum amount of $ and to provide a copy of this policy to the Practice prior to your commencement. 6. Private. This agreement may be amended or assigned by you and the Practice at any time only by an instrument in writing signed by both parties. The Company wishes to appoint the Consultant to provide the service. Responsibility for Taxes. 8. Associate Agreement* INDEPENDENT CONTRACTOR AGREEMENT This Agreement is entered Into as of 200 (the "Effective Date"), by and between Colleen Contractor, D.D.S. 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