Our Service Agreement

This Contract for Services (“Contract”) is made effective as of Click or tap here to enter text.(“Effective Date”) by and between Click or tap here to enter text.(“Recipient/Client Name”) and Reset Mobile Phlebotomy Services, LLC (RMPS) (“Provider”)  

1. Description of Services. Beginning on the Effective Date, the Provider will provide to the Recipient the following services (collectively, “Services”):

is responsible for the drawing and handling of laboratory specimens. RMPS does not collect specimens without a physician’s order or a request from a laboratory. RMPS needs patient information, a copy of the prescription, and a copy of the insurance card (front and back) 48 hours before the scheduled appointment. The scheduled appointment will be canceled if we do not receive the requested information in the mentioned time range. Having adequate time to prepare for the blood draw and perform our job correctly is extremely important. RMPS cannot give medical advice, treat, or diagnose anyone.

RMPS handles the delivery of all samples to their proper laboratory. If the specimen has special handling, we will package all specimens for pick-up via courier at the patient’s home. Under no circumstances will a client be given a sample to handle. RMPS is not responsible for any late arrival at the laboratory due to weather conditions or any other problems that may occur once the courier service delivers or picks up the sample. 

RMPS is not responsible for any errors that may occur at the laboratory. The lab is responsible for processing specimens once received by RMPS. In the event of a lab error, RMPS would gladly return to recollect the sample at a discounted rate.

Any errors in collection caused by RMPS will be corrected by re-drawing at no additional charge. RMPS will make every attempt to contact the patient before the draw. We do not go out unless we have made verbal contact with the patient the night before or the morning of the scheduled blood draw. If we arrive at the blood draw appointment and cannot collect the specimen due to circumstances beyond our control (the patient refuses, is not available to be drawn, etc.), the patient will remain responsible for the full charge of the draw. 

Any errors in collection caused by RMPS (drawing the wrong tubes, unable to obtain a satisfactory blood flow to the specimen, etc.) will not incur a charge to the patient or will be redrawn at no additional charge. 

2. Payment. The Recipient agrees to pay the Provider as follows:

Payment for services must be paid in full when the appointment is scheduled.

3. Billing. The Recipient agrees to and understands the billing process pertaining to the Provider is as follows:

Any billing questions or problems for tests collected for this service should be directed to your insurance company or the laboratory billing department. RMPS does not bill insurance companies, any claims must be submitted by the client, with no reimbursement guarantee. 

Please be advised that RMPS is not responsible for any outstanding balances with LabCorp or Quest and will need to be settled prior to a scheduled home lab draw. The labs have the right to decline specimens of patients with outstanding balances.

RMPS is an independent convenience service. Our company is not affiliated with any laboratories or doctor’s offices. MPS does not have the authorization to give discounts for any lab tests that are being collected.

In addition to any other right or remedy provided by law, if the Recipient fails to pay for the Services when due, the Provider has the option to treat such failure to pay as a material breach of this Contract and may cancel this Contract and/or seek legal remedies. 

4. Privacy. The Recipient agrees to and understands the privacy policy pertaining to the Provider as follows:

Under no circumstances will RMPS give clients' personal information to unauthorized personnel per the HIPAA guidelines. All client information is always kept personal and confidential. RMPS does not receive any results. In the event that your doctor does not receive results, it is the responsibility of the Doctor's office to get in touch with the lab. Most of the time they have an account with the labs.

5. Confidentiality. The Provider and its employees, agents, or representatives will not at any time or in any manner, either directly or indirectly, use for the personal benefit of the Provider or divulge or communicate in any manner any information that is proprietary to the Recipient. The Provider and its employees, agents, and representatives will protect and treat such information as strictly confidential. This provision will continue to be effective after the termination of this Contract. Any oral or written waiver by the Recipient of these confidentiality obligations which allows the Provider to disclose the Recipient\s confidential information to a third party will be limited to a single occurrence tied to the specific information disclosed to the specific third party, and the confidentiality clause will continue to be in effect for all other occurrences. 

6. Cancellation: The Recipient agrees to pay the Provider as follows:

Please be considerate; if an appointment needs to be canceled, RMPS needs to be given a 24-hour notice. We send confirmation out of courtesy; if you are a no-show, you will be charged an additional $25 to reschedule. We make it easy for you to contact us with any questions or concerns. We may only sometimes be available by phone. You can also reach us via email or text.

7. Children: The Recipient agrees to and understands this section of the agreement pertaining to the Provider as follows:

For parents with children: It is important to remember that this is a TEAM effort. If your child is getting their blood drawn, you must do your part. It is vital to keep them hydrated 24 hours prior to the scheduled blood draw—the less stress in the room the higher the success rate. We are almost always successful on the first try. However, it may take up to 3 tries, which must be understood. This is normal, especially with tiny veins and a moving target. We understand how stressful it can be for you and your child during their blood draw, please understand how stressful it can be for us if we do not have understanding parents. Safety is very important. If you know that your child gets aggressive when upset, is challenging to draw, or that it usually takes more than one person to hold them still, it is extremely important that you please let us know so that we can make arrangements to have a safe and successful draw. I understand the above terms and conditions and agree to have my lab (and/or my son/daughter) sample collected.

In addition to any other right or remedy provided by law, if the Recipient fails to pay for the Services when due, the Provider has the option to treat such failure to pay as a material breach of this Contract and may cancel this Contract and/or seek legal remedies.

8. Term. The Contract will terminate automatically upon completion by the Provider of the Services the Client requires.

9. Indemnification. The Provider agrees to indemnify and hold the Recipient harmless from all claims, losses, expenses, and fees, including attorney fees, costs, and judgments that may be asserted against the Recipient that result from the acts or omissions of the Provider and/or the Provider’s employees, agents, or representatives. 

10. Default. The occurrence of any of the following shall constitute a material default under this Contract:

(a) The failure to make the required payment when due.

(b) The insolvency or bankruptcy of either party.

(c) The insolvency or bankruptcy of either party’s property to any levy, seizure, general assignment for the benefit of creditors, application, or sale for or by any creditor or government agency.

(d) The failure to make available or deliver the Services in the time and manner provided in this Contract. 

11. Remedies. In addition to any and all other rights a party may have available according to law, if a party defaults by failing to substantially perform any provision, term, or condition of this Contract (including without limitation the failure to make a monetary payment when due), the other party may terminate the Contract by providing written notice to the defaulting party. This notice shall describe with sufficient detail the nature of the default. The party receiving such notice shall have 14 days from the effective date of such notice to cure the defaults (s). Unless waived in writing by a party providing notice, the failure to cure the default(s) within such time period shall result in the automatic termination of this Contract. 

12. Force Majeure. If the performance of this Contract or any obligation under this Contract is prevented, restricted, or interfered with by causes beyond either party’s reasonable control (“Force Majeure”), and if the party who is unable to carry out its obligations and gives the other party prompt written notice of such event, then the obligations of the party invoking this provision shall be suspended to the extent necessary by such event. The term Force Majeure shall include, without limitation, acts of God, plague, epidemic, pandemic, outbreaks of infectious disease, or any other public health crisis, including quarantine or other employee restrictions, fire, explosion, vandalism, storm, or other similar occurrence, orders or acts of military or civil authority, or by national emergencies, instructions, riots, or wars, or strikes, lockouts, work stoppages or other labor disputes, or supplier failures. The excused party shall use reasonable efforts under the circumstances to avoid or remove such causes of non-performance and shall proceed to perform with reasonable dispatch whenever such causes are removed or ceased. An act or omission shall be deemed within a party's reasonable control if committed, omitted, or caused by such party or its employees, officers, agents, or affiliates. 

13. Dispute Resolution. The parties will attempt to resolve any dispute arising out of or relating to this Contract through friendly negotiations amongst the parties. If the matter is not resolved by negotiation within 30 days, the parties will resolve the dispute using the Alternative Dispute Resolution (ADR) procedure below.

Any controversies or disputes arising out of or relating to this Contract will be resolved by binding arbitration under the rules of the American Arbitration Association. The arbitrator’s award will be final, and any court with proper jurisdiction may enter judgment upon it.

14. Entire Agreement. This Contract contains the parties' entire agreement, and there are no other promises or conditions in any other agreement, whether oral or written, concerning the subject matter of this Contract. This Contract supersedes any prior written or oral agreements between the parties.

15. Severability. If any provision of this Contract will be held to be invalid or unenforceable for any reason, the remaining provisions will continue to be valid and enforceable. If a court finds that any provision of this Contract is invalid or unenforceable but that by limiting such provision, it would become valid and enforceable, then such provision will be deemed to be written, construed, and enforced as so limited. 

16. Amendment. This Contract may be modified or amended if the amendment is made in writing and is signed by both parties. 

17. Governing Law. This Contract shall be constructed in accordance with the laws of Maryland. 

18. Notice. Any notice or communication required or permitted under this Contract shall be sufficiently given if delivered in person or by certified mail, return receipt requested, to the address set forth in the opening paragraph or to such other address as one party may have furnished to the other in writing.

19. Waiver of Contractual Right. The failure of either party to enforce any provision of this Contract shall not be construed as a waiver or limitation of that party’s right to subsequently enforce and compel strict compliance with every provision of this Contract. 

20. Attorney’s Fees and Collection Costs. If there is a dispute relating to any provisions in this Contract, the prevailing party is entitled to, and the non-prevailing party shall pay, the costs and expenses incurred by the prevailing party in the dispute, including but not limited to all out-of-pocket costs of collection, court costs, and reasonable attorney fees and expenses. 

21. Construction and Interpretation. The rule regarding construction or interpretation against the drafter is waived. The document shall be deemed as if it were drafted by both parties in a mutual effort. 

22. Assignment. Neither party may assign or transfer this Contract without the prior written consent of the non-assigning party, whose consent shall not be unreasonably withheld. 

IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed by their duly authorized representatives as of the date first above written.

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The Recipient (Patient, POA, Parent/Guardian)  Date 

Reset  Mobile Phlebotomy Services, LLC (RMPS) 

The Provider  

THE SECTION BELOW SHOULD BE COMPLETED BY THE INTERNAL STAFF ONLY!!!

Click or tap here to enter text. Click or  tap here to enter text.

Owner/Operator/CEO Date: