CARDIAC CONCIERGE - INDEPENDENT CONSULTING AGREEMENT 

INDEPENDENT CONSULTING AGREEMENT

This Independent Consulting Agreement ("Agreement") is entered into by and between:

Dr. H. Barry Raff ("Dr. Raff"), a licensed cardiologist and

[Patient’s Full Name ____________________________________], residing at [Patient’s Address __________________________________________________________________] ("Patient"), collectively referred to as "the Parties."

1. PURPOSE The purpose of this Agreement is to set forth the terms and conditions under which Dr. Raff shall provide independent consulting services to the Patient for the purpose of reviewing prior medical tests and recommending additional diagnostic tests, specialist referrals or consultations as deemed necessary based on Dr. Raff’s medical assessment of the Patient’s condition and health needs.

2. SCOPE OF SERVICES Dr. Raff agrees to provide the following services: a) Review and assess prior medical tests ordered by the Patient’s doctors; b) Recommend additional tests, if necessary; c) Provide referrals or suggest consultations with other medical specialists, as appropriate.

3. LIMITATIONS OF SERVICES a) Dr. Raff will not provide direct medical care, treatment, or prescribe medications. b) This consultation does not replace the Patient’s primary care physician or treating doctors. c) The Patient acknowledges that this Agreement does not establish a doctor-patient relationship for the purposes of ongoing treatment or emergency care.

4. VOLUNTARY PARTICIPATION Both Parties acknowledge that this Agreement is entered into voluntarily and that the Patient understands the nature of the consulting services being provided.

5. LIABILITY WAIVER a) The Patient acknowledges that Dr. Raff is providing consulting services only and is not assuming responsibility for the Patient’s direct medical care. b) The Patient agrees to release and hold harmless Dr. Raff from any and all claims, liabilities, damages, or legal actions arising from the recommendations made under this Agreement. c) This waiver includes, but is not limited to, malpractice claims, misdiagnosis, failure to diagnose, or other health-related legal actions.

6. COMPENSATION The Patient agrees to compensate Dr. Raff for consulting services at the rate of $200 for up to one-hour initial consultation. All optional follow-up and review of any additional testing are $100 for half-hour consultation. Payment shall be made in accordance with the agreed-upon terms prior to the delivery of services. This is not a membership. Each consultation requires a new payment. Follow up Consultations exist for up to 6-months from the date of the first visit.

7. TERMINATION Either Party may terminate this Agreement upon written notice. Any fees due for services rendered prior to termination shall remain payable.

8. GOVERNING LAW This Agreement shall be governed by and construed in accordance with the laws of the State of [Insert State], without regard to its conflict of law principles.

9. ENTIRE AGREEMENT This Agreement constitutes the entire understanding between the Parties and supersedes all prior discussions, agreements, or understandings, whether written or oral, relating to the subject matter herein.

IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the date written below.

Dr. H. Barry Raff
Signature: ________________________
Date: ________________________

[Patient’s Full Name____________________________________]
Signature: ________________________
Date: ________________________