1st Part – Intro Letter 2nd Part – Professional Agreement: What is expected of a SHAPE practitioner 3rd Part – Exhibits A, B & C: Legalese
To help you navigate your annual Professional Agreement, we offer you this guidance. Should you not complete by April 9th 2018, access to the SHAPE shopping cart and Healthcare Professional data on SHAPE’s website will expire. We’ve kept it as simple and streamlined as possible. Completion means:
> Signed electronic Professional Agreement
> Copy/screenshot of active license including name and expiration date
> Open email labeled: Please sign 2018 Account Information Form & Professional Agreement coming from firstname.lastname@example.org
> Click on BLUE link that reads: Click here to review and sign 2018 Account Information Form & Professional Agreement.
> We appreciate you reading our intro letter before completing your Professional Agreement.
> Complete every field starting with “Practitioner Name”. All fields with a * are required.
– Agreement will be incomplete until you answer all required fields, including initial fields on each exhibit page.
– If you tab through each field, you will not miss a required field. Once one field is completed, tab to the next, or click the yellow Next button.
– If you do not have a website, put “N/A”. This field MUST be completed to proceed.
> Once you have completed all required fields, you will see the box below pop up. Click the blue “Click to sign” button.
> Once submitted, you will see the following:
– If you do not see this after submitting, please call SHAPE Central to confirm receipt of completed contract. 636-484-8444.
> Click the “Download a copy” button to download a copy for your records.
> A copy will automatically be sent to SHAPE Central for our records.
Each license copy/screenshot must contain: Name & Expiration Date **Providing a license number does not suffice**
If your professional license has been renewed since April 1, 2017, SHAPE Central does not have a current copy. If your state does not issue a copy of your license, please email a screenshot of your active status.
Best way to stay up-to-date: When you receive (via mail or email) your new license after renewal, email SHAPE Central a copy to: email@example.com.
Every SHAPE practitioner (including practitioners under the umbrella of a primary practitioner or practitioners/business owners who are under contract as “pay only” commitments) must complete and sign the Professional Agreement and submit a copy/screenshot of their active license.
SHAPE Family Reunion January 24-26, 2019
Mark your calendars!
Thursday, 24th: SHAPE Foundation Meet & Greet Friday, 25th & Saturday, 26th: Class (All Day)
Exact times to be determined.
Please Note: Exhibit A: On-Going Training EVERY SHAPE practitioner must attend 1 SHAPE Family Reunion every other year.
Professional Guidelines: Compliance with Physician’s Technical Guidebook Patient Assessment Patient Monitoring On-Going Training SHAPE ReClaimed Product Orders, Sales & Returns
Standard Terms & Conditions: Confidentiality; Protection of Rights Indemnification Assignability Notices Waivers & Amendments Disclaimer of Warranties; Limitation of Liability Interpretation & Enforcement
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