Provider Service Agreement & Sign up

Portland Integration Network

Portland Integration Network, LLC (PIN) is a website that is owned and maintained by a group of local independent practice health care professionals. The purpose of this website is to provide referrals for professional services in a variety of health, healing, and creative professions. All content on the site (https://www.portlandintegrationnetwork.com) is governed by these policies and standards and applies to all individuals who use, access, or are listed on this site.

Disclaimer Related to Laws and Ethics

Portland Integration Network, LLC does not condone the use of the website for the following activities. Please note the “illegal substances” as used here does not include psilocybin under Measure 109, which is legal at the state level

Seeking illegal substances or those who provide them
Offering or selling illegal substances
Offering or selling any service that may be illegal such as providing psychedelic-assisted therapy, “guiding” or “sitting” for individuals where illegal drugs are consumed
Referring to underground practitioners who administer or provide access to illegal substances
Providing services to clients who self-administer illegal substances during the time that you meet with them

Portland Integration Network, LLC reserves the right to remove any Provider or Practitioner at any time for any reason.

Ethical Guidelines for Professionals

Portland Integration Network is interested in providing access to high quality professional services that may be helpful in psychedelic education, harm reduction and integration. Our list of providers must demonstrate and maintain a commitment to ethical values of competency, integrity, and justice.

Licensed providers must be in and maintain good standing with their licensing agency
Unlicensed practitioners must prove adequate education, training, or experience that justifies their offering of services

Providers or practitioners may be removed from PIN under any circumstances which include the following:

Receiving complaints about unethical or unprofessional behavior, such as abuse of power or negligence
Providing, offering, or using illegal substances with any individual in a professional context
Unprofessional behavior in public settings
Receiving disciplinary investigation by a licensing board or law enforcement agency · Any reason

Please note that Portland Integration Network may not offer refunds for payment if removed from the site for violating policies and standards.

Privacy of Information

Portland Integration Network will not share your information with any other organization, business, or outside party for any reason, and your information will remain confidential. Any information that you submit in emails, phone or video conferencing sessions, or application materials may be shared amongst administrators of PIN for the purposes of quality assurance and monitoring of ongoing activity. Exceptions to this include when required to by law enforcement or court order.

While Portland Integration Network will take every reasonable safeguard to keep your information private and confidential, it is important to understand that no method of electronic communication is fully secure from outside threats. Applications, providers, and practitioners are asked to keep this in mind when corresponding via electronic communication such as e-mail.

This PROVIDER SUPPORT SERVICES AGREEMENT (this “Agreement”) is entered by and between the Portland Integration Network, LLC, a limited liability company organized in the State of Oregon (the “Company”) and the person or entity described below (the “Provider”). Exhibit A includes identifying information about the Provider.

FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

The Company will use all reasonable commercial efforts to provide the services described in Exhibit A (the “Services”). The Provider will be one of many integrative health service providers obtaining services from the Company.

The Provider acknowledges that the manufacture, use, possession, or distribution of psychedelic or psychoactive substances may violate federal or state laws. If the Provider violates any such law, then the Provider will be solely responsible for any resulting legal or financial liabilities. If the Provider manufactures, uses, or possesses any psychedelic or psychoactive substance in violation of applicable state or federal law, then the Company may immediately suspend the Services or this Agreement entirely without further liability or obligation to the Provider.

The Provider will pay the Company the fees set forth in Exhibit A according to the terms and schedule also set forth in Exhibit A.

“Confidential Information” means any information owned or controlled by either party that is: a. Proprietary information;

Information marked or designated as confidential;
Any information protected by legal or other privilege, such as the attorney-client privilege or the work product doctrine;
Information, whether or not in written form and whether or not designated as confidential, that either party knows or should reasonably know is confidential; and
Information that either party is otherwise obligated to keep confidential.

Confidential Information will not include any information that is publicly available through lawful means.

Each party agrees to not publicly disclose any Confidential Information of the other without the express written consent of the other party or unless required by law. Each party will exercise reasonable care in safeguarding the other party’s Confidential Information against loss, theft, or other disclosure.

This Agreement will continue until either party terminates this Agreement with thirty (30) days’ notice. When this Agreement is terminated, the Provider will pay any outstanding amounts of money owed to the Company as soon as possible.

GENERAL PROVISIONS

Amendments. This Agreement may be amended only in writing acknowledged by both parties. Exhibits. The exhibits referenced in this Agreement are fully part of this contract.

Force Majeure. Any delay in the performance of any duties or obligations of either party (except the payment of money owed) will not be considered a breach of this Agreement if the delay is caused by a labor dispute, shortage of materials, fire, earthquake, flood, typhoon, blizzard, pandemic, terrorist attack (foreign or domestic), riot, or any other natural or manmade disaster, or any other event beyond the reasonable control of the party. However, a party affected by such an event will still be required to: (1) use reasonable efforts to notify the other party of the circumstances causing their delay; and (2) resume performance as soon as reasonably possible.

Dispute Resolution. Both parties mutually agree that – if they are unable to resolve any dispute related to this Agreement on their own – they will first seek mediation as a way to resolve that dispute. If mediation is unsuccessful, then they will pursue arbitration as the means to resolve that dispute. If arbitration is unsuccessful, then either party may pursue litigation as the means to resolve that dispute.

Any such mediation or arbitration will be conducted by the American Arbitration Association or any other mediation or arbitration service or provider that they both agree on.

Governing Law and Venue. This Agreement will be interpreted and governed by the laws of the State of Oregon. Any court action or proceeding seeking to interpret or enforce this Agreement will brought in in Multnomah County Circuit Court of the State of Oregon or the United States District Court for the District of Oregon.

Entire Agreement. This Agreement (including Exhibit A) constitutes the entire agreement and understanding of both parties with respect to the subject matter of this Agreement and supersedes all prior understandings and agreements, whether written or oral, among the parties with respect to such subject matter.

EXHIBIT A: IDENTIFICATION OF PROVIDER AND SERVICES PROVIDED

Company provides the following services in support of all members of its Provider Network:

Advertising of services on the PIN website
Seeking approval from provider if suggesting changes to submitted content for website
Reporting any significant website changes not involving provider content within two business days
Responding to requests for communication within 3 business days
Providing invoices for all financial transactions
Maintaining confidentiality of all communications between company and provider

Provider can also expect Company to:

Maintain commitment to ethical and legal standards by requiring compliance from all providers
Apply standards equally to all providers
Not discriminate based on age, race, gender identity, sexual preference, or any other aspect of identity
Not share provider information with any other organization, business, or outside party However,

Company will not support or engage in services outside the scope of this Agreement such as:

Facilitating access to illegal drugs
Becoming involved in matters occurring between providers and clients who contact them using PIN such as disputing conflict, etc.
Providing direct clinical services

Application and Agreement

Name of the provider:

Provider’s mailing address:

Provider’s primary place of business:

Phone

The Provider is:

Please list any assumed business names that the Provider uses:

Please describe the services that the Provider offers:

I HEREBY ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE OF LIABILITY, THAT I FULLY UNDERSTAND ITS CONTENTS, AND THAT I HEREBY VOLUNTARILY AGREE TO THE TERMS STATED ABOVE.

PORTLAND
INTEGRATION
NETWORK

Portland Integration Network