___________________________ (THE “CONTRACTOR”)


THIS AGREEMENT is made on the ………… of………….20……., (hereinafter, “Effective Date”) entered into by the Company and the Contractor (Company and Contractor collectively referred to as the “Parties” or individually as the “Party”) and includes that Party’s successors and assigns.


WHEREAS the Company is a behavior consultation company that develops individualized behavior support plans for individuals with intellectual disabilities and trains the individual’s family/staff/caregivers on implementation of the plans;

WHEREAS the Contractor is a Health Service Provider in Psychology (HSPP); and 

WHEREAS the Company desires to acquire the Contractor’s services, the Contractor agrees to provide their services per the terms of this Agreement.

In consideration of covenants and agreements contained in this Agreement, and other good and valuable consideration, the receipt of which is hereby acknowledged, Parties agree to the following terms and conditions and to be bound thereby:


This agreement shall be valid from the Effective Date until _____________________date.


The Services provided by the Contractor to the Company are of reviewing and signing all documentation, providing monthly consultation to all staff, and each individual served, attesting that the correct diagnosis is in place with the appropriate functional analysis, and valid behavioral data, attesting that behavioral data is collected, determining if appropriate psychotropic usage is at levels which are appropriate to diagnosis, and signing the behavior plan at least annually. The Contractor shall also perform any other duty assigned by the Executive Director, who shall be their supervisor.

The Contractor warrants and represents that they are qualified to offer the Services; they shall provide the Services diligently and per acceptable industry standards.

The Contractor’s role shall be as follows;

  • Receive a copy of every behavior support plan and monthly report;
  • Certify the diagnosis and the plan for treatment;
  • Complete a Level I Clinician report indicating that they have done the review monthly;
  • Sign the monthly reports during or after the monthly HSPP supervision. During this time, they shall bring the Level I Clinician report for each Client and turn them in together electronically to file. The Contractor’s supervisor also signs these documents;
  • If the Contractor’s supervisor has concerns about a behavior plan or a monthly report, they will bring this to the Consultant’s attention during HSPP. The owner of the Company will also participate in the discussion. If changes need to be made, he will wait for the revisions before signing any document. 
  • Sign Clients’ behavior support plan signature pages and complete an analysis of Clients’ targeted behaviors and behavioral health with the level 2 consultant during the HSPP review. The owner of the Company Owner will typically also be present during this discussion and analysis.
  • All Consultants have the HSPP supervisor’s phone number when consultation is needed. The owner of the Company will often discuss various issues with the HSPP supervisor.

The Company will pay the Contractor $__________________for the Services, which will be due on or before the _________day of the month in respect of which the rent is payable.


For the duration of this Agreement, any subsequent agreement executed for the same or similar purpose, and after the termination of this Agreement, the Contractor shall not directly or indirectly interfere with the Company’s relationship with, or endeavor to entice away from the Company, the Company’s Clients, any officer, director or employee or any person who had a material business relationship with the Company in the duration of this Agreement.


The Contractor agrees to indemnify, hold harmless and defend the Company and its directors, officers, employees, and agents from and against any action, claim, demand, or liability, including reasonable attorney’s fees and costs, arising from or relating to: (i) the Contractor’s breach of this Agreement; (ii) the negligence or willful misconduct of the Contractor; or (iii) any allegation that the Contractor caused injury or damage to any third Person (“Person” is defined as any individual, corporation, company, partnership, government or any other entity). The Contractor agrees that the Company shall have the right to participate in and control the defense of any such claim through counsel of its choosing at the Contractor’s expense.


The relationship of the parties hereto is that of an independent contractor. Accordingly, the Parties hereto are not deemed agents, partners, or joint venturers of the others for any purpose due to this Agreement or the transactions contemplated thereby. The Company is not required to pay or make any contributions to any social security, local, state, or federal tax, unemployment compensation, workers compensation, insurance premium, profit-sharing, pension, or any other employee benefit for the Contractor during the term. The Contractor is responsible for paying and complying with reporting requirements for all local, state, and federal taxes related to payments made to the Contractor under this Agreement. The Contractor hereby agrees that it will not represent to any third party that its engagement by the Company is in any capacity other than as an independent contractor.


The Contractor shall not transfer or assign this Agreement without the Company’s consent. However, the Company may transfer or assign this Agreement or subcontract its obligations hereunder at any time without the Contractor’s consent. If the Company does so, anyone to whom the Company transfers, assigns, or subcontracts any or all of its obligations will have all of the Company’s rights with respect to such obligations. 


Upon the expiration or termination of this Agreement or demand by the Company, the Contractor shall return any of the Company’s property to the Company, including but not limited to; documentation, records, or confidential information. All property should be returned in the same condition at issuance failure to which damages shall become payable. Reasonable wear and tear will be allowed.

The Contractor shall reimburse the Company for any Company property lost or damaged in an amount equal to the market price of such property.


Parties agree to settle disputes under this Contract through the following methods: (select one) 

☐Negotiation                        ☐Mediation                                 ☐Arbitration                       ☐Litigation

  • Either Party may terminate this Agreement, at any time upon giving the other Party no less than ________notice in writing. If a Party wishes to terminate the Contract with less than this stated period, the other Party reserves the right to charge costs that they have already paid in advance or incurred. 
  • The termination of this Agreement shall not discharge the liabilities accumulated by either Party.
  • Any Clauses intended by the Parties or this Agreement to survive the termination of this Agreement shall survive the termination of this Agreement by whatever cause.

All non-public, confidential or proprietary information of the Company, disclosed by the Company to the Contractor, whether disclosed orally or disclosed or accessed in written, electronic or other form or media, and whether or not marked, designated or otherwise identified as “confidential” in connection with this Agreement is confidential, solely for the use of performing this Agreement and may not be disclosed or copied unless authorized in advance by the Company in writing. Upon the Company’s request, the Contractor shall promptly return all documents and other confidential materials received from the Company. The Company shall be entitled to injunctive relief for any violation of this Section. This Section does not apply to information that is: (a) in the public domain; (b) known to the Contractor at the time of disclosure, or (c) rightfully obtained by the Contractor on a non-confidential basis from a third party.

In addition, this Agreement is confidential and cannot be divulged to third parties, unless as provided by law, without the written consent of the Company.


Either Party may request changes to the Agreement, but they will only be effective if agreed in writing, signed by all Parties, and recorded. If any ambiguity is found in the Agreement or various documents forming this Agreement, the Parties shall issue any necessary clarification or instruction.


Unless otherwise provided, failure by the Company to enforce any of the terms or conditions of this Agreement shall not be a waiver of their right to enforce the terms and conditions of this Agreement. A waiver by the Company of any right or benefit provided in this Agreement does not infer or permit a further waiver of that right or benefit, nor does it infer or permit a waiver of any other right or benefit provided in this Agreement.


The provisions of this Agreement are severable. If any provision is held to be invalid or unenforceable, it shall not affect the validity or enforceability of any other provision.


This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original and all of which taken together shall constitute one instrument.


This Agreement constitutes the entire Agreement between the parties. It supersedes all prior oral or written agreements or understandings between the Parties concerning the subject matter of this Agreement. All documents annexed to this Agreement shall be subject to the terms under this Agreement, provided that the Parties append their signatures on the documents. The Parties will exercise utmost good faith in this Agreement.


The article and section headings in this Agreement are for convenience; they form in no part of this Agreement and shall not affect its interpretation.


All pronouns and any variations thereof shall be deemed to refer to the masculine, feminine, neuter, singular, or plural, as the identity of the person or entity may require. As used in this Agreement: words of the masculine gender shall mean and include corresponding neuter words or words of the feminine gender, and words in the singular shall mean and include the plural and vice versa.


Any notice required to be given between the Parties pursuant to the provisions of this Agreement shall be in writing and shall be deemed to have been given at the time when actually received as a consequence of any effective method of delivery at the following addresses (including email) or such changed address as the Party shall have specified by written notice, provided that any notice of change of address shall be effective only upon actual receipt.

Company: _________________________________________________________________________

Contractor: ________________________________________________________________________


The Contractor acknowledges that they have been provided with the opportunity to negotiate this Agreement and to seek legal counsel before signing this Agreement. In addition, the Contractor acknowledges that they have entered into this Agreement with the capacity and authority to contract freely and voluntarily.


This Agreement shall be governed in all respects by the laws of the State of Indiana and its Courts without regard to its conflict of law provisions.

IN WITNESS WHEREOF, each of the Parties has executed this Agreement, as of the day and year set forth below.

Signed by the duly authorized representative of the COMPANYSignature: Name: Designation: Date:…………………………………………………. Signed by the CONTRACTOR
Signature : Name: Date:…………………………………………….……
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