This Release, Hold Harmless, and Acknowledgment (“Acknowledgment”) is entered into by the undersigned Licensed Therapy Provider (“Provider”).
In consideration for the Museum allowing Provider to use designated space within the Museum premises for the purpose of conducting therapy services, Provider agrees as follows:
1. Independent Provider Status
Provider acknowledges and agrees that:
- Provider is an independent professional and is not an employee, agent, contractor, partner, joint venturer, or representative of the Museum.
- The Museum does not supervise, control, direct, or evaluate the clinical services provided by Provider.
- The Museum does not provide therapy, medical, psychological, behavioral, or counseling services of any kind.
- Provider is solely responsible for all professional services delivered on the premises
2. Hold Harmless and Indemnification
Provider agrees to defend, indemnify, and hold harmless the Museum, its officers, directors, employees, volunteers, insurers, and representatives from and against any and all claims, demands, causes of action, damages, liabilities, losses, costs, or expenses (including reasonable attorney’s fees) arising out of or related to:
- Any therapy, counseling, assessment, or related services provided by Provider;
- Any act or omission of Provider, its employees, contractors, or agents;
- Any alleged professional malpractice, negligence, misconduct, or failure to provide appropriate care.
- This indemnification obligation applies to any claims brought by clients, patients, parents/guardians, or third parties arising from Provider’s services.
3. Confidentiality and HIPAA Compliance
Provider acknowledges that the Museum is not a healthcare provider and is not responsible for maintaining patient confidentiality.
Provider agrees that:
- Provider is solely responsible for compliance with all applicable federal, state, and local laws governing patient privacy and confidentiality, including but not limited to HIPAA and applicable Louisiana privacy laws.
- Provider shall take all necessary steps to protect client confidentiality while on Museum premises.
- Provider shall ensure that conversations, records, and electronic communications are secured in accordance with professional and legal standards.
- The Museum shall have no liability for any breach of confidentiality arising from Provider’s actions, omissions, or security practices.
4. Disclosure to Clients / Informed Notice
Provider certifies and agrees that:
- Each client and/or parent/guardian will be clearly informed that:
- The Museum is not providing therapy services;
- The Museum’s role is limited solely to providing physical space;
- The Museum does not endorse, supervise, or assume responsibility for Provider’s services.
- Such disclosure will be included in Provider’s intake paperwork and/or informed consent documents.
- Provider shall provide confirmation of this disclosure to the Museum upon request.
5. Professional Licensure and Insurance
Provider represents and warrants that:
- Provider holds all current, valid, and unrestricted licenses required to practice in the State of Louisiana.
- Provider maintains professional liability (malpractice) insurance in commercially reasonable amounts.
- Provider will provide proof of licensure and insurance, upon request.
6. No Agency or Partnership
Nothing in this Agreement shall be construed to create a partnership, joint venture, employment, or agency relationship between Provider and the Museum.
7. Governing Law
This Agreement shall be governed by and construed in accordance with the laws of the State of Louisiana.
8. Entire Acknowledgment
This Acknowledgment constitutes the entire understanding regarding Provider’s use of Museum space for therapy services and supersedes any prior oral or written agreements on this subject.