You can open the Collaborative Practice Agreement Template in multiple formats, including PDF, Word, and Google Docs.
Collaborative Practice Agreement Template Printable | Editable FormSample
[Name of the Collaborative Practitioner 1]
[Practitioner 1’s ID]
[Practitioner 1’s Address]
[Practitioner 1’s Phone]
[Practitioner 1’s Email]
[Name of the Collaborative Practitioner 2]
[Practitioner 2’s ID]
[Practitioner 2’s Address]
This agreement is established to outline the terms and conditions under which both parties will engage in a collaborative practice, commencing on [Contract Start Date].
The purpose of this agreement is to facilitate a collaborative approach to [Specify purpose], whereby both practitioners will work together to provide comprehensive services to clients.
Each practitioner agrees to fulfill the following responsibilities: [List specific responsibilities for each practitioner].
Both practitioners agree to charge a fee of [Amount] for services, to be divided as follows: [Specify terms of payment and distribution].
Both parties shall maintain strict confidentiality regarding all client information and collaborative discussions, except as required by law.
In case of disputes arising from this agreement, both parties agree to engage in mediation prior to pursuing any legal actions.
This agreement shall remain in effect until [Specify duration] or until terminated by either party with [Specify notice period] written notice.
This agreement shall be governed by the laws of [Jurisdiction].
[Signature of the Collaborative Practitioner 1]
[Name of the Collaborative Practitioner 1]
[Signature of the Collaborative Practitioner 2]
[Name of the Collaborative Practitioner 2]
[Name of the Collaborative Practitioner 1]
[Practitioner 1’s ID]
[Practitioner 1’s Address]
[Practitioner 1’s Phone]
[Practitioner 1’s Email]
[Name of the Collaborative Practitioner 2]
[Practitioner 2’s ID]
[Practitioner 2’s Address]
This agreement outlines the collaborative practice framework between the parties for the provision of services starting on [Contract Start Date].
The primary objective is to provide [Specify objectives] through a combined practice model, enhancing service delivery.
The Collaborative Practitioners agree to undertake the following obligations: [List specific obligations].
Both parties will be compensated as follows: [Detail the compensation arrangement].
The parties agree to protect the confidentiality of all sensitive information shared during the course of practice.
A clear process for resolving disputes has been established: [Outline dispute resolution process].
The agreement remains effective until [Specify duration] and may be terminated under specific conditions: [Specify conditions for termination].
The terms of this agreement shall conform to the laws of [Jurisdiction].
[Signature of the Collaborative Practitioner 1]
[Name of the Collaborative Practitioner 1]
[Signature of the Collaborative Practitioner 2]
[Name of the Collaborative Practitioner 2]
Form
Please complete the form below to create the Collaborative Practice Agreement Template. All fields must be filled out to ensure a clear and comprehensive agreement. We provide examples to guide you through each step. Collaborative Practice Agreement Template 1. Participants Information 2. Agreement Overview 3. Purpose of the Collaboration 4. Roles and Responsibilities 5. Confidentiality Agreement 6. Conflict Resolution Process 7. Duration of the Agreement 8. Amendments to the Agreement 9. Signatures and Acceptance 10. Declaration and Signatures
PDF
WORD
Collaborative Practice Agreement Template Printable | Editable FormPrintable
