Effective upon signature · Month-to-month · Fee billed monthly
Guided setup runway
Time to get practice-ready
Physician in place
A collaborator from day one
Then Basic or Full-Scope
Migrate anytime
This StartUp Tier Collaboration Agreement (“Agreement”) is entered into through the NubridgeMD platform between the Nurse Practitioner (“NP”) and the Collaborating Physician (“Physician”) identified in the signature block below. NubridgeMD facilitates this collaboration but is not a party to the clinical relationship.
1. Purpose of the StartUp Tier
The StartUp Tier is a supportive collaboration designed for new Nurse Practitioners at the very start of their practice. Its aim is to give the NP a structured runway — with a committed collaborating Physician in place — to complete the business and regulatory groundwork required to practice. NubridgeMD created this tier to care for and support new NPs from the very beginning of their business growth.
2. Term & billing
This Agreement takes effect upon signature and continues on a month-to-month basis. The StartUp Tier fee is billed monthly (see Section 5). Either party may end the collaboration on reasonable written notice, and the NP may migrate to another tier at any time (see Section 6).
3. What the StartUp Tier is for
During the StartUp Tier, the NP will use the collaboration and Physician support to complete setup items that may include, as applicable: practice documentation and business formation; state-required registrations and licensure steps; DEA registration where necessary; credentialing and payer enrollment; and any other Physician-required setup processes for the collaboration.
4. No controlled substance prescriptions
Under the StartUp Tier, the NP shall not prescribe any controlled substances, including any medication in DEA Schedules II–V. All care and prescribing must comply with applicable federal and state law, the NP’s scope of practice, and the collaborating Physician’s requirements. Controlled substance prescribing may only occur after the NP has transitioned to an active collaboration tier that expressly permits it (Section 6).
5. Fees
The StartUp Tier fee payable by the NP is $350 per month, billed monthly while enrolled in the StartUp Tier.
Of this monthly amount, the Physician receives $300 per month and NubridgeMD retains $50 per month.
In addition, a one-time non-refundable fee of $200 applies. The NP acknowledges and agrees that this $200 is non-refundable under any circumstances, including early termination or non-completion of setup.
6. Migration to other tiers
The NP may migrate to either the Basic Tier or the Full-Scope Tier at any time, based on the NP’s completed setup and collaboration needs. Continued collaboration, patient care, and prescribing — including any controlled substances, where permitted — are governed by the terms and pricing of that subsequent tier.
7. Signatures & execution
This Agreement is signed by the NP and the Physician only. The NP signs first, may download a copy, and sends it to the collaborating Physician, who executes the Agreement by e-signing or by manually (wet-ink) signing the copy. By signing, each party confirms they have read, understood, and agree to the terms above, including the no-controlled-substance restriction (Section 4) and the fees (Section 5).
1
Nurse Practitioner signs
Nurse Practitioner
Signature
Sign above using your mouse or finger.
Collaborating Physician
The physician executes the Agreement after the NP signs — by e-signing the copy you send (Step 3) or by manually signing the downloaded copy. The physician can also e-sign here directly if present.
Physician is here now — e-sign on this device
Collaborating Physician
Signature
Sign above using your mouse or finger.
2
Download your copy
Type your legal name, draw your signature, and accept the e-signature consent above to sign as the NP.
3
Send to the collaborating physician to execute
Send the agreement to your physician to e-sign or manually sign and execute. They’ll receive a secure e-signature link by email; once they sign, you both get the executed copy. (If email delivery isn’t available, we’ll open your mail app so you can attach the copy you downloaded in Step 2.)