Medical director and prescriber agreement checklist

Medical IV Hydration Business | PublicProof Academy working document

Walks through every clause a prescriber agreement for an IV hydration business needs before you sign it.

Business

State or jurisdiction

Prepared on

Owner

Official source saved

Next review

Credentials verified before signing

Active license in THIS state verified on the board's own lookup (write the date)
License number and expiration recorded
Any prior board discipline searched and documented
Own professional liability policy in force, certificate on file
DEA registration status recorded (only if any controlled substance is on the menu)
Specialty and comfort with elective infusion documented

Clinical scope clauses

How each patient is evaluated: in person or telehealth (confirm your state allows telehealth for this)
Whether standing orders are lawful in this state, and if so exactly what they cover
Requirement for a new evaluation when the plan or additives change
Availability during an infusion: on site, by phone, or by video - stated in minutes
Menu items the prescriber has approved, in writing, item by item
Written screening exclusions the prescriber will not treat

Oversight and documentation

Frequency of chart review and what percentage of charts
Who signs off on protocol changes and how often the protocol is reviewed
Incident and adverse event reporting path and timeline
Records retention: who holds the chart and for how long
Access rights if the relationship ends

Continuity and risk

Named backup prescriber and their credentials on file
Notice period required before the prescriber may terminate
What happens to prepaid packages if the agreement ends
Indemnity and insurance requirements both directions
Fee structure reviewed by a health care attorney for fee-splitting and corporate-practice risk
Confirmation the arrangement is not payment for referrals

Use rule: Education and organization only. Record the agency, official source, checked date, cost, proof saved and responsible person for every consequential requirement. Unknown means stop and confirm. Example rows are labeled EXAMPLE and are not your data.