app.pandadoc.com
Open in
urlscan Pro
45.223.20.103
Public Scan
Submitted URL: https://email.email.pandadoc.net/c/eJxVUU1PhDAQ_TX0JukyhcKBg-y6IbtZE40a9WKmHyxV2mIpGv31otGoyRxeXmbeR-bVh6dpRKkfjKrDerO1Wdt4u137x2...
Effective URL: https://app.pandadoc.com/p/4e4605d7c6b8a89f43c4b370570383ce3753f080?tool=forward
Submission: On May 31 via api from US — Scanned from DE
Effective URL: https://app.pandadoc.com/p/4e4605d7c6b8a89f43c4b370570383ce3753f080?tool=forward
Submission: On May 31 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="Form-qx2gn8-0 biKWMa"><span class="GhostSpan-c5rsli-0 eEKGyW">Experity Service Order Addendum for Memorial Hermann 5.27.2022</span><input readonly="" class="Input-sc-1p0w8u6-0 iwaBGz"
value="Experity Service Order Addendum for Memorial Hermann 5.27.2022" style="width: 612px;"></form>Text Content
Öffnet in einem neuen Fenster Öffnet eine externe Website Öffnet eine externe Website in einem neuen Fenster <!---->Schließen Sie diesen Dialog<!----> Auf dieser Website werden Daten wie Cookies gespeichert, um wichtige Funktionen der Website sowie Marketing, Personalisierung und Analyse zu ermöglichen. Sie können Ihre Einstellungen jederzeit ändern oder die Standardeinstellungen übernehmen. Sie können dieses Banner schließen, um nur mit essenziellen Cookies fortzufahren. Datenschutzerklärung Einstellungen verwalten Alle akzeptieren Alles ablehnen <!---->Schließen Sie die Cookie-Einstellungen<!----> RevisionsCreated with Sketch.ImgReviewCreated with Sketch. Experity Service Order Addendum for Memorial Hermann 5.27.2022 BY SHAMPIIA HUNTER JL TT JC Other actions Please fill in 4 required fields. Start EXPERITY SERVICE ORDER ADDENDUM FOR MEMORIAL HERMANN 5.27.2022 1 of 1 document SERVICE ORDER - ADDENDUM Client: Memorial Hermann Prepared By: Jordan Collis Effective Date: Date of Last Signature Initial Term: Coterminous with the term of the Agreement Facility: Listed Below Client Contact Name: Tonya Thomas Client Address: 300 North Loop West Suite #100 Houston, TX 77008 Primary Contact Phone: 713-897-2389 Primary Contact Email: tonya.thomas@memorialhermann.org This Service Order is between the client identified above (“Client”) and Experity, Inc., a Delaware corporation (“Experity”) as of the Effective Date set forth above. This Service Order supplements and is otherwise governed by the terms of the Master Agreement attached to the Initial Service Order between Client and Experity, any addendums thereto, and the Addendums attached hereto (collectively, the “Agreement”). Capitalized terms used in this Service Order but not defined herein will have the meaning given to them in the Agreement. Each of Experity and Client may be referred to individually as “Party” and collectively as the “Parties”. CLINIC LOCATION(S): Business Office/Patient Registration --- 9250 Pinecroft Drive, The Woodlands, TX 77380 Implementation and Professional Services Billing Terms Amount Clockwise.MD Implementation One-time per clinic, upfront $100.00 Standard Add-ons and Interfaces Billing Terms Amount Urgent Care Queue Clockwise.MD Urgent Care Queue * Easy online scheduling * Automatic queue placement (acuity based) * Wait-time transparency * Text reminders and alerts * Single-system management of walk-ins and online self-schedulers * In-lobby queue view * Door-to-door benchmarks and reports Per clinic, monthly $259.00 CLIENT: By (Signature):____________________________________________ Name (Printed):__________________________________________ Title: ____________________________________________________ Date: ____________________________________________________ Signature Select date EXPERITY, INC. By (Signature):____________________________________________ Name (Printed): Jared Lisenby Title: SVP Sales Date: ____________________________________________________ 05 / 31 / 2022 Download latest revision All revisions uploaded back into PandaDoc are stored here to view and download. ALL ATTACHMENTS WILL BE STORED HERE AND CAN BE DOWNLOADED. Download all ATTACHED BY SENDER FORWARD DOCUMENT Allow this person to sign the document instead of me To Tonya Thomas forwarded "Experity Service Order Addendum for Memorial Hermann 5.27.2022" to you Forward Cancel Documents: 1 Experity Service Order Addendum for Memorial Hermann 5.27.2022 2 PAGES 1 SERVICE ORDER - ADDENDUM Client: Memorial Hermann Prepared By: Jordan Collis Effective Date: Date of Last Signature Initial Term: Coterminous with the term of the Agreement Facility: Listed Below Client Contact Name: Tonya Thomas Client Address: 300 North Loop West Suite #100 Houston, TX 77008 Primary Contact Phone: 713-897-2389 Primary Contact Email: tonya.thomas@memorialhermann.org This Service Order is between the client identified above (“Client”) and Experity, Inc., a Delaware corporation (“Experity”) as of the Effective Date set forth above. This Service Order supplements and is otherwise governed by the terms of the Master Agreement attached to the Initial Service Order between Client and Experity, any addendums thereto, and the Addendums attached hereto (collectively, the “Agreement”). Capitalized terms used in this Service Order but not defined herein will have the meaning given to them in the Agreement. Each of Experity and Client may be referred to individually as “Party” and collectively as the “Parties”. CLINIC LOCATION(S): Business Office/Patient Registration --- 9250 Pinecroft Drive, The Woodlands, TX 77380 Implementation and Professional Services Billing Terms Amount Clockwise.MD Implementation One-time per clinic, upfront $100.00 Standard Add-ons and Interfaces Billing Terms Amount Urgent Care Queue Clockwise.MD Urgent Care Queue * Easy online scheduling * Automatic queue placement (acuity based) * Wait-time transparency * Text reminders and alerts * Single-system management of walk-ins and online self-schedulers * In-lobby queue view * Door-to-door benchmarks and reports Per clinic, monthly $259.00 2 CLIENT: By (Signature):____________________________________________ Name (Printed):__________________________________________ Title: ____________________________________________________ Date: ____________________________________________________ Signature Select date EXPERITY, INC. By (Signature):____________________________________________ Name (Printed): Jared Lisenby Title: SVP Sales Date: ____________________________________________________ 05 / 31 / 2022