Physician Services Agreement Template

This Physician Services Agreement is made on [Date] by and between:

Client: [Hospital / Clinic / Medical Group / Company Name]
Address: [Address]

Physician: [Physician Full Name]
Address: [Address]

1. Services

The Client engages the Physician to provide the following professional services:

[patient care services]
[medical oversight]
[supervisory services]
[on-call coverage]
[telemedicine services]
[consulting services]
[other physician services]

The Physician will provide only the services described in this Agreement unless the parties agree otherwise in writing.

2. Service Location and Scope

The services will be provided at:

[Facility Name / Address / Remote Platform / Other]

The Physician’s service scope includes:

[Describe specialty, department, patient population, hours, or assigned duties]

3. Term

This Agreement begins on [Start Date] and continues until [End Date], unless ended earlier under this Agreement.

The services shall be provided on the following basis:

☐ full-time
☐ part-time
☐ as-needed coverage
☐ fixed schedule
☐ consulting engagement
☐ other: [Describe]

4. Schedule and Availability

The Physician shall provide services according to the following schedule:

[Days / Hours / Shifts / Call Coverage]

Scheduling notes, if any:

[Insert details]

Any schedule change, coverage change, or absence notice shall be handled as follows:

[Insert terms]

5. Compensation

The Client shall pay the Physician as follows:

☐ hourly rate of [$Amount] per hour
☐ per-shift rate of [$Amount]
☐ annual compensation of [$Amount]
☐ monthly fee of [$Amount]
☐ consulting fee of [$Amount]
☐ other: [Describe]

Payment terms:

☐ upon receipt of invoice
☐ within [Number] days of invoice date
☐ payroll schedule
☐ monthly
☐ other: [Describe]

6. Expenses and Benefits

Expenses and benefits shall be handled as follows:

☐ no separate expenses reimbursed
☐ pre-approved business expenses reimbursed
☐ benefits provided as follows: [Describe]
☐ other: [Describe]

Additional terms, if any:

[Insert details]

7. Licensure and Credentials

The Physician represents that the Physician holds and will maintain all required licenses, registrations, certifications, privileges, and professional qualifications needed to perform the services.

The Physician shall promptly notify the Client of any suspension, restriction, investigation, lapse, or disciplinary action affecting the Physician’s ability to provide services.

8. Compliance and Standards

The Physician agrees to perform services in a professional manner and in compliance with:

applicable laws and regulations;
facility bylaws, rules, and policies, if applicable;
professional standards of care;
documentation and recordkeeping requirements;
privacy and confidentiality obligations.

Additional compliance terms, if any:

[Insert details]

9. Insurance

The following insurance terms apply:

☐ Physician shall maintain professional liability insurance
☐ Client shall provide professional liability coverage
☐ coverage shall be shared or provided as follows: [Describe]

Coverage details, if applicable:

[Insert policy limits or coverage notes]

10. Medical Records and Confidentiality

Medical records, patient information, and other confidential information shall be handled in accordance with applicable privacy laws, facility policies, and professional obligations.

Ownership and control of records shall be handled as follows:

[Insert terms]

11. Independent Contractor or Employment Status

The Physician shall serve as:

☐ independent contractor
☐ employee
☐ other: [Describe]

If the Physician is an independent contractor, the Physician is responsible for the Physician’s own taxes, business expenses, and related obligations unless this Agreement states otherwise.

12. Termination

Either party may terminate this Agreement:

☐ on [Number] days’ written notice
☐ immediately for material breach
☐ immediately for loss of license, credential, or required authorization
☐ immediately for patient safety or compliance concerns
☐ under the following additional terms: [Describe]

If this Agreement ends early, payment for services properly performed and approved costs already incurred shall remain due unless otherwise agreed in writing.

13. Governing Law

This Agreement shall be governed by the laws of the state of [State].

14. Entire Agreement

This Agreement contains the full understanding between the parties regarding the physician services described above and replaces prior discussions on the same subject unless otherwise stated in writing.

15. Signatures

Client Signature: __________________________
Name: [Full Name]
Title: [Job Title]
Date: [Date]

Physician Signature: __________________________
Name: [Physician Full Name]
Date: [Date]