AGREEMENT

This agreement executed at Vapi, Gujarat on _________, 2019, between

……………………. Hospital having registered office at Vapi, Gujarat, hereafter referred as

First party. The party is exclusive offer hospital services in Vapi.

And

__________________ ______________having registered office at _________________, here

forth referred as Second Party

Under this agreement First party would like to utilize the services of Pharmacy for the patient in
compliances with the medical requirement of the patient. The main elements of the services to
be covered by this agreement are

 Pharmacy services to the hospital patient on priority

 Provision of all drugs to be available as per the Hospital’s Drug Formulary
 Provision to follow all rules and regulation by the provider as per government rules

Role and Responsibility of First Party

 To provide correct details of the patient as per in given format required to the second
party
 To Provide an inhouse space of approx. _________ sq ft and run in the name of
_____________________
 To follow proper guidelines for prescribing of the patient as and when required
 Guide the patient regarding prescription and also share the same information with the
second party as and when required

Whereas, Role and Responsibility of Second Party

 To follow all rules and regulations as the guidelines of competent authority

 To display the Pharmacy License in the premises
 The quality of the medicines and storage as per its requirements
 Counseling of the patients as and when required
 Ensure to follow proper quality and safety standards for the best patient safety practices
 The charges should not be vary from fixed by the competent authority and share with
the first party
 All financial transactions to be manage by second party and First party will not lie any
responsibility for payment from the patient in any circumstances.
Other Terms:-

 Both parties will ensure to maintain best practices for patient safety and welfare
 Both parties mutually agree to go in the agreement for an initial period of 5 five years.
The contract can be extend with mutually agreed terms. However, both parties can
terminate the agreement with advance notice of 90 days if any breach of contract.
 Any dispute is limited to Vapi Judiciary area only

Authorized Signatory

For First Party For Second Party

………………………………Hospital, Vapi

Witness for First Party Witness for Second Party