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AND
WITNESSETH
WHEREAS, the FIRST PARTY is engaged in hemodialysis treatment and other services related
to renal care and desires to engage the services of the SECOND PARTY for the required laboratory
examinations.
WHEREAS, the SECOND PARTY is engaged in laboratory business fully equipped with
facilities and equipment, well qualified/trained personnel to provide medical and diagnostic services.
NOW THEREFORE, for in consideration of the foregoing premises, the parties hereto have
agreed the following terms and conditions:
1. This Agreement shall take effect for a period of one (1) year commencing on ________
up to and shall be automatically renewed unless terminated upon
written notice of at least thirty (30) days prior to the expiry date of the Agreement.
2. SERVICES - That this Agreement shall cover all medical and laboratory examinations
requested by the FIRST PARTY to the SECOND PARTY.
3. That the FIRST PARTY shall be the one to determine the schedule of pick-up of the
SECOND PARTY.
4. That the FIRST PARTY shall ensure and observe the proper preparation of specimen such as
proper labeling, complete patient’s demographics, and correct amount of blood needed.
5. The integrity of the results shall always be observed by the SECOND PARTY. In cases when
there will be panic values or critical values, the FIRST PARTY will be notified immediately.
6. TERMS OF PAYMENT – Cash basis upon pick-up. An official receipt will be issued upon
payment.
7. RELEASE OF RESULTS – Test results and report dates are estimated as accurately as
possible at the time the requests are received. The hard copy results will be delivered by the
SECOND PARTY after one (1) working day except for some tests that requires long
incubation time. The SECOND PARTY will be responsible to inform the FIRST PARTY
regarding the expected turn-around time. The results can also be sent via electronic mail
upon request of the FIRST PARTY.
IN WITNESS WHEREOF, the parties have affixed their signatures in this
__day of 2019.
ACKNOWLEDGEMENT
SSS NO.
Known to me to be the same persons who executed the foregoing instrument and they acknowledged to me the
same are their free and voluntary act and deed and that of the company they represent.
The foregoing instrument consists of two (2) pages including this page on which the acknowledgement is written
signed at the margin of each and every page thereof by the parties and their instrument witnesses.
IN WITNESS THEREOF, I hereunto set my hand and affix my notarial seal this day of
2019.
Doc. No.
Page No.
Book No.
Series No.
NOTARY PUBLIC