Patient Connect Corporate Promotions Agreement

Date

Your title

Name*

First NameLast Name

Name of Business*

Email*

example@example.com

Mobile Phone Number*

Main Work Address

Street Address

Street Address Line 2

City

Country

Other Work Address

Street Address

Street Address Line 2

City

Country

Assistant's Name

First NameLast Name

Assistant's Mobile Phone Number

Assistant's Email

example@example.com

Corporate Promotions (Exhibit A on Agreement)- Note all ads below are for illustration purposes only.*

Corporate Promotion for 1 month

Per Month

250.00TTD Quantity

Corporate Promotion for 3 months

3 months

750.00TTD Quantity

Corporate Promotion for 6 months

6 months

1,500.00TTD Quantity

Corporate Promotion for 1 year

Per annum

2,700.00TTD Quantity

Enter coupon

Total

0.00TTD

Start date for your Corporate Promotion(Exhibit B on Agreement): *

Date

Story 1 (Add Heading, Sub-heading, story and links)

Please upload your ad/image #1

Story 2 (Add Heading, Sub-heading, story and links)

Please upload your ad/image #2

Story 3 (Add Heading, Sub-heading, story and links)

Please upload your ad/image #3

Story 4 (Add Heading, Sub-heading, story and links)

Please upload your ad/image #4

Story 2

Story 3

Story 4

Pay Here
There are a couple ways to pay for your Corporate Promotions.

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ATTENTION: The Invoice will be sent to your email when you click submit. Due to HIPAA privacy a password will be required to open the Invoice.

Invoice Password: PatientConnect123!

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Credit card
Pay with your credit card using our WiPay portal.

CREDIT CARD

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Online Banking
Pay from your online bank account at any bank to Republic Bank.
ACH Bank Transfer:

Patient Connect Ltd.

Republic Bank, Gulf View

Chequing Account

#740801267201

Please ensure you put your company name in the payment remarks to ensure payment is accurately processed.

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If you need any assistance, please WhatsApp 492-2428 or 492-CHAT or click here

Payment receipt (if applicable)

Service Provider Service Agreement

Panama Office: Paciente Conectar S.A., P.O. Box 0823-03548, Panama, Republic of Panama&#13;&#10;Trinidad Office: 37-39 Princess Margaret Street, San Fernando, Trinidad&#13;&#10;Miami Office: 306 8th Ave SW Largo, FL 33770, USA &#13;&#10;admin@patientconnectt.com&#13;&#10;Tel: 1-868-475-8123&#13;&#10;&#13;&#10;Service Agreement between Patient Connect Ltd. (Trinidad & Tobago) and Service Provider&#13;&#10;&#13;&#10;We are pleased to present this service agreement, outlining the terms and conditions that will govern the mutually beneficial partnership between Patient Connect Ltd. (Trinidad & Tobago), the vendor, and the Service Provider as per this agreement.&#13;&#10;&#13;&#10;Service Name: “Patient Connect Online Services”- chat-based care services for subscribers of the online platforms operated by Patient Connect Ltd., Trinidad and Tobago.&#13;&#10;&#13;&#10;Services: Patient Connect will provide chat-based care services including mental health counselling, medical and specialist care, fitness, wellness, dietitian and nutritional support, pharmacy, dental, physiotherapy, vet, optical, financial, legal, and other support services to subscribers who engage these services.&#13;&#10;&#13;&#10;SALES AGREEMENT&#13;&#10;&#13;&#10;This Sales Agreement ("Agreement") is entered into as of date above, between Patient Connect, and [The Service Provider named under Name of Business], hereinafter referred to as "The Advertiser."&#13;&#10;&#13;&#10;1. SERVICES:&#13;&#10;&#13;&#10;Patient Connect agrees to provide advertising services as outlined by the following:&#13;&#10;An entire page on the Patient Connect's Chat-based care platform where the Advertiser will provide Corporate Promotions with a heading, sub-heading, story, ad/image or images of the product/service and relevant links to your website or social media pages. This page will be available to the users/subscribers of the platform, and may from time to time be shared to users/subscribers through the platform or other social media platforms.&#13;&#10;&#13;&#10;2. PAYMENT:&#13;&#10;&#13;&#10;The Advertiser agrees to pay Patient Connect the total amount of based on Exhibit A for the services rendered. Payment shall be made according to the payment schedule outlined in Exhibit A.&#13;&#10;&#13;&#10;3. TERM AND TERMINATION:&#13;&#10;&#13;&#10;This Agreement shall commence on agreed date based on Exhibit B and continue for a period  based on Exhibit A unless terminated earlier by either party with written notice. Termination shall not relieve The Advertiser of its obligation to pay for services rendered up to the date of termination.&#13;&#10;&#13;&#10;4. REPRESENTATIONS AND WARRANTIES:&#13;&#10;&#13;&#10;4.1 Patient Connect's Representations:&#13;&#10;Patient Connect represents that it has the right to provide the advertising services and that such services will be performed in a professional and timely manner.&#13;&#10;&#13;&#10;4.2 Advertiser's Representations:&#13;&#10;The Advertiser represents that it has the authority to enter into this Agreement and is responsible for the content of the advertising materials provided.&#13;&#10;&#13;&#10;5. INDEMNIFICATION:&#13;&#10;&#13;&#10;The Advertiser agrees to indemnify and hold Patient Connect harmless from any claims, damages, or liabilities arising out of the content of the advertising materials or any breach of this Agreement.&#13;&#10;&#13;&#10;6. CONFIDENTIALITY:&#13;&#10;&#13;&#10;Both parties agree to keep confidential any proprietary or sensitive information disclosed during the course of this Agreement.&#13;&#10;&#13;&#10;7. GOVERNING LAW:&#13;&#10;&#13;&#10;This Agreement shall be governed by and construed in accordance with the laws of Trinidad & Tobago.&#13;&#10;&#13;&#10; Signatory: Dr. Navi Muradali, MD For: Patient Connect Ltd. Title: CEO&#13;&#10;E-signature verified

Signature

Read this checklist carefully before clicking SUBMIT

Patient Connect Corporate Promotions Agreement

What does Corporate Promotion mean?

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