Medical Practice Partnership Dissolution Agreement

1. Parties

2. Recitals

3. Dissolution Date

4. Distribution of Assets and Liabilities

5. Patient Records

6. Notices

7. Confidentiality

8. Governing Law

9. Miscellaneous

10. Signatures

Partner 1: _______________________

Date: _______________________

Partner 2: _______________________

Date: _______________________

Witness: _______________________

Date: _______________________