Clinician 2 Clinician
Medical Consultation Agreement

This Agreement (“Agreement”) is entered into between:

clinician Name: *

Phone *

Email *

AND
Dr. Monica Jauregui / [Your Clinic Name], hereinafter referred to as the “Provider.”

1. Purpose

Clinician desires to engage Consultant for educational and advisory support in the areas of internal medicine and functional medicine. Consultant agrees to provide such support in a peer-to-peer, non-clinical capacity.

2. Nature of Services

Consultant may provide advice, case reviews, clinical pearls, literature references, treatment frameworks, or other professional insights.

These services are educational only and are not intended to replace the Clinician’s independent clinical judgment. The Consultant is not providing medical care, and no doctor-patient relationship is formed with any third parties (i.e., Clinician’s patients).

3. No Medical Liability or Responsibility

Clinician understands and agrees that:

Consultant is not responsible for diagnosing, treating, or managing any patient under the Clinician’s care.
Consultant does not assume liability for any medical decisions, outcomes, or patient harm.
Consultant's role is limited to providing educational input based on her own experience, knowledge, and training.

Clinician retains full responsibility for all medical decisions and patient care, and agrees to indemnify and hold harmless the Consultant from any and all claims, damages, losses, or legal actions arising out of or related to patient care decisions made by the Clinician.

4. Compensation

Clinician agrees to compensate Consultant as follows:

Rate: $249 per [hour/session/case]
Payment Terms: [e.g., Due within 14 days of invoice; late fees may apply]
Method: [e.g., ACH, credit card, check, etc.]

5. Confidentiality

Each party agrees to maintain the confidentiality of any personal or health information shared during consultation, consistent with HIPAA guidelines, professional ethics, and applicable laws.

Note: Patient-identifying information should be de-identified or anonymized whenever possible.

6. Term and Termination

This Agreement will commence on the date above and may be terminated by either party with written notice. Any consultations completed prior to termination remain payable in full.

7. Governing Law

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