Health Care Proxy Materials Letter of Understanding

This Letter of Understanding is provided to confirm the terms under which HealthAdvocateX will make its Health Care Proxy Materials available to you, as follows:

HealthAdvocateX Health Care Proxy Materials:

• Advocate Discussion and Health Care Decision Guide Tool for the Health Care Proxy
• Health Care Proxy Letter of Agreement Template
• Health Care Proxy/HIPAA Card Templates

Purchase Price – $500, payable on execution of this Letter of Understanding

Use Authorization – The Health Care Proxy Materials are made available on a nonexclusive basis,
for the limited purpose of your provision of health care advocacy services, either personally or
through a legal entity in which you own a controlling interest. Please understand that these
materials are provided to you for use within the scope of this Use Authorization only, as-is and
without warranty. In particular, these are templates only, and HealthAdvocateX does not warrant that any
agreements comply with the laws of your State. These rights may not be transferred in any
manner and these materials may not be distributed to third persons in any form (other than in
the direct course of your using them in providing services within the scope of this Use Authorization), without HealthAdvocateX’s prior written consent.

Please confirm your agreement with these understandings by checking the Letter of Understanding agreement checkbox and completing payment.

Best regards,
Robin Shapiro, Board Chair