MTN HLTH Provider Agreements – Electronic Signature

MTN HLTH Provider Agreements

Please review and sign each agreement below. Click a section to expand, read the full text, and complete your electronic signature for that specific contract.

Agreement
Use your mouse, trackpad, or finger (on mobile) to sign.
Your signature, timestamp, and technical details (including IP address) will be stored with this Agreement.
Please sign this agreement and complete all required fields.
A signed copy of this Agreement will be emailed to you after submission.
Agreement
Sign to acknowledge your HIPAA Business Associate responsibilities.
Signature, timestamp, IP address, and device details will be stored with this Agreement.
Please sign this agreement and complete all required fields.
A signed copy of this Agreement will be emailed to you after submission.
Agreement
Sign to acknowledge Confidentiality & PHI Security obligations.
Signature, timestamp, IP address, and device details will be stored with this Agreement.
Please sign this agreement and complete all required fields.
A signed copy will be emailed to you after submission.
Agreement
Sign to acknowledge Telemedicine Compliance obligations.
Signature, timestamp, IP address, and device details will be stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge Non-Compete & IP obligations.
Signature, timestamp, and technical details stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to confirm licensing & malpractice compliance.
Signature, timestamp, and device details will be stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge Technology Use obligations.
Signature, timestamp, and technical details stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge Conflict of Interest & Independent Contractor Status.
Signature and device details will be stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge the Compensation Addendum.
Signature, timestamp, IP, and device details will be stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge Clinical Quality & Performance Standards.
Signature, timestamp, IP address, and device details will be stored.
Please sign this agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge 1099 tax responsibility.
Signature, timestamp, IP, and device details will be stored.
Please sign the agreement.
A signed copy will be emailed after submission.
Agreement
Sign to acknowledge full responsibility for AI safety and PHI de-identification.
Signature, timestamp, IP address, and device details will be stored.
Please sign this agreement.
A signed copy will be emailed after submission.