Provider consultation agreement

Healthcare Provider Consultation Agreement and Liability Waiver

This Healthcare Provider Consultation Agreement and Liability Waiver ("Agreement") is made as of [Insert Date below], by and between [Consulted Professional's Name below], [Consulted Professional's Title] ("Consultant"), and [Consulting Healthcare Provider's Name] ("Consulting Provider").

WHEREAS, the Consultant has been asked to provide expert review and/or consultation regarding a patient's care prior to, or in the course of, the Consulting Provider's delivery of healthcare services ("Consultation");

WHEREAS, the Consultant will review and provide an opinion based on the information provided by the Consulting Provider, but will not conduct an independent clinical evaluation of the patient, and thus cannot offer recommendations regarding the best course of treatment considering the patient's full clinical factors;

NOW, THEREFORE, in consideration of the opportunity to engage in the Consultation and provide expert opinions, the parties agree as follows:

Nature of Consultation

The Consulting Provider agrees that the Consultant is not providing any medical advice or clinical care on behalf of Breech Without Borders, but rather on behalf of themselves as a private healthcare provider independent from Breech Without Borders. 

The Consultant agrees to provide expert review and opinion regarding certain clinical data, techniques, evaluation criteria, evidence and alternative courses of treatment. The Consultant's opinion is based solely on the information provided by the Consulting Provider and does not include an independent evaluation of the patient or the patient's medical records. As such, the Consultant is not in a position to make specific treatment recommendations that account for the full clinical circumstances of the patient. The Consultant may provide information regarding medical techniques, treatment options, or evidence-based practices, but these should not be interpreted as definitive recommendations for the patient's care.

The Consultant will not be responsible for, nor make any recommendations regarding, the overall treatment plan for the patient. The ultimate responsibility for deciding the best course of treatment remains with the Consulting Provider, who should evaluate the Consultant's feedback in light of the patient's complete clinical history and circumstances.

No Guarantee of Outcome

The Consultant does not guarantee or make any representations as to the outcome of the patient's treatment or condition, and nothing in this Agreement should be construed as such. The Consultant's opinions are based on available information at the time of the consultation and should be considered informational in nature. The Consulting Provider should exercise independent professional judgment when integrating this feedback into their overall patient care plan.

Release of Liability

The Consultant agrees to provide their opinion and expertise in good faith, based on the information made available to them. To the fullest extent permitted by law, the Consultant shall not be held liable for any acts, omissions, or consequences related to the advice, opinions, or recommendations made during the Consultation, including but not limited to any adverse outcomes resulting from the patient's treatment.

The Consulting Provider agrees to release, indemnify, and hold harmless the Consultant from any and all claims, damages, or liabilities arising from the Consultation. The Consulting Provider further acknowledges that the final decisions regarding patient care and treatment remain with the Consulting Provider, and that the Consultant's role is solely advisory.

Confidentiality

The Consultant agrees to maintain the confidentiality of all patient information shared during the Consultation, in accordance with applicable privacy laws. The Consulting Provider acknowledges that the Consultant will only have access to the information provided for the purposes of the Consultation and will not independently collect or evaluate any patient data.

Governing Law and Jurisdiction

This Agreement shall be interpreted and governed in accordance with the laws of the State of Indiana.

Entire Agreement

This Agreement represents the entire agreement and understandings of the parties with respect to the subject matter herein, and may not be changed or modified, in whole or in part, except by an instrument in writing signed by the parties.

Severability

If any provision of this Agreement shall be held or made invalid by a court decision, statute or rule, or shall be otherwise rendered invalid, the remaining portion or portions shall be considered severable and not be affected by such invalidity, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be illegal or invalid.

Acknowledgment and Agreement

By signing below, the Consulting Provider and the Consultant acknowledge that they have read, understood, and agree to comply with the terms and conditions of this Agreement.