STANDARD TERMS AND CONDITIONS OF SALE
RECITALS:
A. Evitalin is a group purchasing organization (“GPO”), which secures contracts for the provision of goods, and
services (the“Contracts”) by vendors (the “Contracted Vendors”) to participating providers (the “Provider”) upon
favorable terms.
B. Provider desires to be eligible to purchase goods and services from the Contracted Vendors upon favorable terms
pursuant to the Contracts.
AGREEMENTS:
1. Evitalin shall enter into such Contracts with such Contracted Vendors, as it determines. From time to time,
Evitalin shall supply Provider with a current list of the Contracted Vendors and their prices. Provider shall be
entitled, at its sole discretion, to purchase goods and services from the Contracted Vendors subject and pursuant
to the terms of the applicable Contract. Provider hereby appoints Evitalin as its purchasing agent with respect to
the Contracted Vendors; PharmaLabs LLC and Wells Pharmacy Network, LLC.
2. Provider hereby directs Contracted Vendors to treat Provider as a Evitalin Provider, regardless of whether Provider
may have or currently participates in other GPO arrangements. Provider agrees to keep all price lists and other
proprietary information in strictest confidence whether supplied by Evitalin or the Contracted Vendors.
3. Evitalin is acting solely as a GPO and Provider hereby releases, indemnifies and holds harmless Evitalin from and
against any claims (including reasonable attorneys fees), which may be asserted against Evitalin relating to or
arising from the provision or the failure to provide any goods and services to Provider by a Contracted Vendor.
4. Evitalin and Provider acknowledge that there are no fees (cost) to the provider for participation in the GPO.
5. This Agreement may be terminated at any time, by either party, with or without cause, upon 15 days written
notice to the other.
6. Provider/Account must transmit all orders to Evitalin's contracted vendors as an original prescription/PO,
facsimile prescription/PO, or electronic prescription/PO. All purchases under the Agreement will be for the
Provider/Account or its patients’ “own use’’ as that term is defined in judicial or legislative interpretation and
not for resale to anyone other than the end user. Evitalin may terminate the Agreement immediately in the
event it reasonably determines that a Provider/Account is in breach of this paragraph.
7. All products indicated on the prescription/PO shall be shipped to the specified address in accordance with the
general delivery schedules and delivery method. The Provider/Account is accepting full responsibility regarding
the delivery of the prescription/PO. In the event the shipping vendor indicates a successful delivery for a non-
signature required package and the recipient states the package was not delivered, the Provider/Account will be
responsible for payment of a replacement prescription/PO
8. Evitalin must be notified within 48 hours of receipt of goods if any products are missing from the shipment.
Shortages not identified within the 48-hour-window will not be subject to replacement or reimbursement. A new
prescription/PO must be issued by the prescriber and additional payment will be required.
9. Provider/Account will pay a purchase price for all products purchased under the agreement specified in the
pricing matrix “Practice Pay Price Catalog” plus all applicable taxes or other assessments on such purchases.
Evitalin reserves the right to adjust such prices based on contracted vendor rates
– Provider/Account must remit payment in full to Evitalin no later than 30 days (30) for all products delivered and
services provided to the provider/account during the subsequent calendar month
– Products cannot be returned. If you received a damaged package or there is a discrepancy in your order, please
call your Evitalin account manager immediately or our physician line (857) 233-5837 x2 so we can remedy the
situation with the contracted vendor.
PharmaLabs 503A PRESCRIBER STATEMENT
This Provider Agreement is by and between PharmaLabs and “Prescriber Account” wherein each of the
parties agrees as follows:
1. Prescriber Account acknowledges this purchase is from PharmaLabs for a specific patient of Prescriber Account’s
practice.
a. Prescriber Account authorizes PharmaLabs to make recurring charges to my payment method. All records are
kept in a secure file accessible to authorized personnel only. All payments are due upon receipt and unpaid
balances may lead to late payment penalties and account closure.
2. PharmaLabs agrees that it provides patient specific compounded preparations to the Prescriber Account subject
to the terms of this Provider Agreement.
3. Each of the Parties agree to the following terms:
a. Any patient specific compounded preparations prepared by PharmaLabs are received by Prescriber Account as
an agent of the patient and shall not be redispensed to the patient of the Prescriber Account or dispensed to
any third party or entity;
b. The Prescriber Account will provide all packaged literature to the patient for the medication usage instruction
and for the reporting of any adverse reaction or complaint in order to facilitate any recall of batches of
compounded preparations.
4. PharmaLabs maintains a record of all patient specific compounded preparations distributed to the Prescriber
Account as an agent of the patient and such records shall include the date of the prescription, name, address,
and phone number of the prescriber who ordered the preparation and the name, strength and quantity of the
preparation ordered and the LOT number of each preparation.