This signed contract will be emailed directly to ASK Dental Staffing at askdentalstaffing@gmail.com. A completed PDF copy of the contract, including the entered practice information and electronic signature, will be attached. The authorized signer will also receive a copy at the email address entered above.
Dental Office Contract
This agreement is made between ASK Dental Staffing LLC, a staffing agency, and [Employer], with an office located at [Office Address] (the “Employer”). In consideration of the following terms and conditions, the parties agree as follows:
1. Temporary Placement
a. Placement of Temporary Workers. ASK Dental Staffing LLC shall provide the Employer with Dental Hygienist, Dental Assistant, Dental Receptionist (“Workers”) at such times and places as may be requested by the Employer. All such Workers shall be licensed in the State of New York, if licensing is applicable. The Employer shall be responsible for the supervision of the Worker in accordance with accepted dental practices in the State of New York.
b. Schedule of Fees. Upon invoice, the Employer shall pay ASK Dental Staffing LLC as follows:
| Position | Fee | 4 hour day / 1/2 day fee |
|---|
| Dental Assistant | $30.00 / day | $16.00 |
| Dental Hygienist | $35.00 / day | $18.00 |
| Dental Receptionist | $26.00 / day | $14.00 |
c. Method of Payment
- The Employer shall be charged for only worked days.
- The shortest temporary staffing assignment that may be requested is four (4) hours. If patients cancel or are canceled by the office, the worker will still be paid for the assigned hours.
- All payments are due upon receipt or fifteen (15) days from the date of invoice. All overdue invoices will be charged a $10.00 late fee each month. Payment may be made by check or an approved electronic payment method.
- Keeping a credit or debit card on file is optional. An Employer may choose to securely store a payment method through Square for future payments. If a card is kept on file, ASK Dental Staffing LLC may charge amounts due only in accordance with the Employer's card-on-file authorization and the payment terms of this agreement.
- The Employer must pay the Worker through his/her payroll for the day, at the end of the day. ASK Dental Staffing LLC is not responsible for payroll.
2. Permanent Placement
a. Amount of fee: Upon hiring a permanent worker, or converting a temporary worker to a permanent status, the Employer shall pay ASK Dental Staffing LLC a permanent placement fee equal to 6% of the worker's estimated annual income for the first full year of employment. With respect to estimated annual incomes, ASK Dental Staffing LLC, Employer, and the worker should make such an estimate at the time the worker accepts the position of permanent employment. All temporary fees must be paid in full prior to permanent hire of an applicant.
b. Fee due on engagement: Placement fees are due if Employer engages the services of a worker that has been referred or introduced to the Employer, directly or indirectly by ASK Dental Staffing LLC, or if Employer refers a worker for either permanent or temporary employment to another dental office or company.
c. Replacement of Employee: Reimbursement of fee. If within 90 days from the date that the Worker commenced permanent employment, the permanent worker is terminated, resigns or ceases to be employed by Employer for any reason, Employer shall have the option to:
- obtain a replacement worker at no additional charge OR
- apply for reimbursement from ASK Dental Staffing LLC as follows:
| Length of Employment | Percentage of Reimbursement |
|---|
| 1 to 30 days | 100% |
| 31 to 60 days | 60% |
| 61 to 90 days | 30% |
EMPLOYER MUST NOTIFY ASK DENTAL STAFFING LLC WITHIN THE FIRST 3 MONTHS FOR REIMBURSEMENT OR REPLACEMENT TO APPLY
If the personnel-doctor relationship is terminated between 1 and 30 days, the doctor will be liable for temporary fees for the days the candidate worked in his or her office.
d. Method of payment: ASK Dental Staffing LLC shall invoice the Employer when the worker commences employment. Payment in full is due within 7 business days. Payment may be made by check or an approved electronic payment method. If the Employer has voluntarily placed a card on file and authorized its use, ASK Dental Staffing LLC may charge amounts due in accordance with that authorization.
3. General Provisions
The provisions of Section Three shall be applicable to the placement of temporary and permanent workers with the Employer.
a. Term of Agreement; Entire agreement. Except provided herein, the term of this agreement shall be for a period of one year from the execution hereof. This agreement is automatically renewed annually. Any party wishing to void this renewal should do so in writing. This agreement constitutes the entire agreement between the parties and there are no representations, warranties or agreements, express or implied, except set forth herein. The terms of this agreement may be modified only by written agreement signed by each of the parties hereto.
b. Acceptance of referrals. The recall or employment of any worker shall be conclusive evidence of Employer's acceptance of the terms of this agreement unless a written modification has been signed.
c. Restrictions. Employer recognizes that ASK Dental Staffing LLC has substantial investment in all of the workers listed on its registry. During the contract, Employer agrees that:
- Employer shall notify ASK Dental Staffing LLC immediately upon recalling any temporary or permanent worker.
- Employer shall refrain, unless Employer pays the applicable permanent placement fee set forth in Section 2 (Permanent Placement) of this agreement, from engaging the services of a Worker that has been referred or introduced to the Employer, directly or indirectly, by ASK Dental Staffing LLC, or from referring a Worker for either permanent or temporary employment to another dental office or company.
d. Representations; Indemnification.
- Employer acknowledges that ASK Dental Staffing LLC is acting as the agent of Employer to provide Employer with workers on a temporary and permanent basis. ASK Dental Staffing LLC shall use its best efforts to ensure that all workers are fully licensed in the State of New York. ASK Dental Staffing LLC assumes no responsibility for the supervision of any worker placed with the Employer and assumes no responsibility for any representations made by a worker.
- Employer further agrees to indemnify, defend and hold harmless ASK Dental Staffing LLC from any and all liabilities, obligations, damages, penalties, claims, costs, charges and expenses, including without limitation reasonable attorney's fees, which may arise from the performance of the worker.
e. Late Payment: In the event of any failure by the Employer to make payments, a late fee of $10.00 per month will be charged. In addition, ASK Dental Staffing LLC shall be entitled to reimbursement by Employer of all costs and reasonable attorney's fees incurred by ASK Dental Staffing LLC in connection with the collection of any amounts owed or in connection with the enforcement of any rights under this agreement.
- Please be sure your staff is familiar with our policies, as the Doctor will be held responsible for the actions of the staff.
- You cannot ask a temporary for their phone number.
- You cannot ask a temporary to return to your office for additional temporary or permanent work without prior notification to ASK Dental Staffing LLC.
- You cannot refer a temporary to another dental office for work or ask for a temporary referral of friends looking for work.
- If you have been initially introduced to an applicant through ASK Dental Staffing LLC and the applicant later answers an advertisement, submits a resume, application, etc., the dental office is still liable for the permanent placement fee because the initial introduction was from ASK Dental Staffing LLC, regardless of the manner in which the offer of employment was made.
- If an applicant has applied for work prior to ASK Dental Staffing LLC sending this applicant to you, but no offer of employment was made by you, your initial acceptance of the worker constitutes an “introduction” from ASK Dental Staffing LLC and the permanent placement fee is due.
- All temporary bills must be paid prior to hiring a temporary worker as a permanent employee.
- A permanent placement fee is due even if the person is hired by your office to perform different duties on a permanent basis than those for which they were originally referred. For example, a dental assistant who later obtains a dental hygiene license.
In witness whereof, the parties hereto have duly executed this agreement as of the date below.
ASK Dental Staffing LLC
Employer e-signature
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Employer: [Employer]