Confidentiality Agreement

AGREEMENT AND ACKNOWLEDGEMENT OF CONFIDENTIALITY AND LIABILITY FOR UNAUTHORIZED DISTRIBUTION

I hereby acknowledge and agree that all of the information I receive, whether electronic, written or oral, associated with practices listed with Practice Brokers, Inc., is strictly confidential and cannot be distributed by any means or in any manner, to any person or entity, whatsoever, without the express written authority of the selling doctor and Practice Brokers, Inc.

I understand that distribution, by whatever means, without first obtaining proper written authority, may be unlawful and that as a result, the selling doctor and Practice Brokers, Inc., may pursue any and all legal claims and actions against me or my agents in a court of competent jurisdiction. I hereby agree that as a condition of obtaining this information from Practice Brokers, Inc., I will not permit, authorize, allow or participate in any way, in the distribution of any of the confidential information pertaining to the selling doctor without first obtaining proper written authorization from Practice Brokers, Inc.

THIS FORM MUST BE DATED, SIGNED AND RETURNED TO PRACTICE BROKERS, INC. PRIOR TO THE DISTRIBUTION OF INFORMATION. NO ADDITIONAL INFORMATION REGARDING ANY PRACTICE WILL BE PROVIDED UNTIL THIS DOCUMENT IS SIGNED AND ON FILE AT PRACTICE BROKERS, INC.

The parties to this Agreement acknowledge that for all purpose relating to this document, electronic signatures shall be deemed the equivalent of original signatures.

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