Pharmacy Services Agreement Template
This pharmacy services agreement, entered into by and between the following parties: [Sender.FirstName][Sender.LastName], the Provider, AND [Client.FirstName][Client.LastName], the Client, is created as of [Document.CreatedDate].
WHEREAS,
the Provider is properly licensed, willing, and able to provide such services,
WHEREAS,
the Client wishes to engage with the Provider to provide on-site pharmacy staffing and services at the Client’s facility located at Client.Address, and
THEREFORE,
the Provider and Client agree to enter into this pharmacy service agreement in accordance with the following:
I. Agreement Term
This pharmacy agreement shall cover a period of (Agreement.Years), beginning on [Document.CreatedDate].
II. Provider Responsibilities
The Provider shall offer on-site staffing of the Client’s pharmacy during the following hours:
Monday-Friday | |
|---|---|
Saturday | |
Sunday | |
Public Holidays | |
Additionally, the Provider shall be responsible for the following:
Provide consultation to patients regarding proper use of prescribed medications
Perform periodic inventory of all pharmacy products
Enact and enforce an approved quality assurance program
Partner with the Client to develop, review, and implement approved policies and procedures regarding pharmacy operation
Maintain an accurate database of patient and medication information in compliance with State and Federal standards
III. Client Responsibilities
The Client ensure that their on-site pharmacy is properly stocked and equipped in a manner acceptable to the Provider.
The Client shall install and maintain safeguards to adequately secure the on-site pharmacy from intrusion by unauthorized individuals.
The Client shall provide access to the on-site pharmacy to the Provider’s employees during the hours listed in this pharmacy services agreement.
IV. Payment
The Provider shall deliver an invoice to the Client for services rendered on the first business day of each calendar month. Each invoice shall contain an itemized breakdown of charges, and shall be due for payment within 30 business days. The table below outlines the fees that will be charged to the Client by the Provider.
Name | Price | QTY | Subtotal |
|---|---|---|---|
Item 1 Description of first item | $35.00 | 5 | $175.00 |
Item 2 Description of second item | $55.00 | 1 | $55.00 |
Item 3 Description of third item | $200.00 | 1 | $200.00 |
Subtotal | $230.00 |
Discount | -$115.00 |
Tax | $23.00 |
Total | $138.00 |
V. Independent Contractor
The Provider shall be considered an independent contractor and is not an employee of the Client.
VI. Indemnification
Both parties to this pharmacy services agreement agree to indemnify and hold one another harmless against all damages and loss except in cases of gross negligence or willful misconduct.
VII. Formal Communication
All formal notices shall be delivered via the following means:
VIII. Governing Law
This pharmacy services agreement shall be enforced and governed in accordance with the laws of Sender.Country and Sender.State.
IX. Agreement Modification
This pharmacy agreement shall not be modified except through written amendment signed by both parties.
X. Entire Agreement
This pharmacy services agreement shall constitute the entire agreement between the Client and Provider.
Acceptance
IN WITNESS WHEREOF, the below signed parties hereby agree to enter into this pharmacy agreement with one another.
[Sender.FirstName][Sender.LastName]
[Client.FirstName][Client.LastName]
