APPENDIX A. SAMPLE MEMORANDUM OF UNDERSTANDING

Date

Address

Dear _______________ :

I am pleased to have the opportunity of working with you and your staff advising you regarding pharmacy services. To ensure complete understanding between us, I am setting forth the terms of my engagement and the nature of the services I will provide. I understand that you will provide me with all of the basic information required and that you are responsible for the accuracy and completeness of that information to the best of your knowledge. I will advise you about appropriate pharmacy law and its application to your facility. I will attend appropriate meetings and be available for consultation.

In addition, I will provide:

•

•

•

•

My ___________ fee for these services will be ___________ for the clinic, etc. My invoices will be ___________ rendered ___________ and are payable upon presentation. This agreement is cancelable by either party on a 30-day notice.

I appreciate the opportunity and look forward to be of service to ___________ clinic and believe this letter accurately summarizes the significant terms of our engagement. If you have any questions, please let me know. If the foregoing is in accordance with your understanding, please sign the copy of this letter and return to me.

Very truly yours,

John Smith, PharmD.

Approved by: _____________________________

Title: ____________________

Date: ____________________