It is hereby agreed by between the undersigned parties to this agreement that Solaris will release the medical records listed below to the above-named Patient in a manner, form, and according to a time to be agreed upon by and between the undersigned parties upon the execution of the within agreement, and so long as Solaris is in receipt of the balance due and owing for services rendered, if any, from the above-named Patient.

It is hereby agreed by and between the undersigned parties to this agreement that upon release of the medical records listed above, the parties hereto discharge one another of any and all professional responsibility related to the above-named Patient’s care under Solaris. Additionally, the above-named Patient hereby agrees to indemnify and hold Solaris harmless from all claims, causes of action, and/or damages resulting from any medical protocol followed, professional medical recommendation(s) made, and/or any directions(s) given by any other person or entity other than Solaris after the effective date of the within agreement, i.e., after the termination of Solaris’ care.

It is hereby agreed by and between the undersigned parties that all understandings between the parties hereto are merged into this agreement, which alone fully and completely expresses their understandings.

This Release may not be modified or terminated except by written agreement executed by both parties hereto.

This Release is intended to be performed in the State of New Jersey and shall be construed and interpreted according to the laws of the State of New Jersey. The courts of the State of New Jersey shall have jurisdiction to hear and determine any claims or disputes pertaining directly or indirectly to this agreement and any matter arising therefrom.

This Release shall be binding upon the parties hereto and upon their agents, successors, executors, administrators, and assigns.

In the event any provision of this Release is held to be unenforceable, for any reason, the remainder of this agreement shall be considered severable and shall be entitled to enforcement.

Two or more duplicate originals of this agreement may be signed by the parties, each of which shall constitute an original and all of which together shall constitute one and the same instrument.

The parties agree not to sue one another for any claim released in this agreement and not to seek or accept any monetary relief through any legal, equitable, and/or administrative proceedings.