05/05/2026
TCF LAB SERVICE LLC
MASTER SERVICE AGREEMENT (MSA)
Mobile Phlebotomy & Specialized Collection Services**
This Agreement is entered into by and between TCF Lab Service LLC (βTCFβ), owned and operated by Evelina Kissentaner, CEO & Founder, Master Phlebotomist (35+ Years Experience), and:
Client/Facility Name: __________________________________________
Effective Date: ______________________
1. SCOPE OF SERVICES
TCF agrees to provide mobile and on-site services including, but not limited to:
* Mobile Phlebotomy (Standard & Specialty)
* Specialized Gentle Draw (Dementia, Anxiety, Pediatric, Difficult Veins)
* Homebound Patient Blood Collection
* Drug & Alcohol Testing (DOT & Non-DOT)
* DNA / Paternity Testing
* Specimen Processing, Handling, and Shipping
* Mobile Cash Laboratory Services
All services are performed in compliance with applicable healthcare and safety standards.
2. SERVICE STRUCTURE (UNBUNDLED PRICING MODEL)
Services are billed separately (βunbundledβ) to ensure transparency:
* Draw Fee (Standard or Specialty)
* Mileage / Travel Fee
* Processing / Handling Fee
* After-Hours / STAT Fees (if applicable)
Client agrees that each component is a separate charge unless otherwise agreed in writing.
3. BILLING OPTIONS (SELECT ONE OR MORE)
β Per-Patient / Per-Visit Fee
Client is billed per individual patient service performed.
β Daily Rate
Flat daily rate: $________ (up to ____ patients per day)
β Weekly Arrangement
Flat weekly service rate: $________
β Custom Contract Pricing
As agreed in written addendum.
4. PAYMENT TERMS
* Payment is required PRIOR to service, unless Client has an approved account
* Approved accounts may be invoiced with Net ___ terms
* TCF reserves the right to pause or refuse services for unpaid balances
* Late payments may incur a 5% late fee
Accepted Payment Methods:
Zelle | Cash App | Venmo | PayPal | Credit Card | Approved Invoice Accounts
5. CREDIT CARD ON FILE AUTHORIZATION
Client agrees to maintain a valid credit card on file for recurring or scheduled services.
TCF is authorized to charge:
* Completed services
* Late cancellations / no-shows
* Outstanding balances
6. CANCELLATION & NO-SHOW POLICY
* Cancellations less than 2 hours before appointment may incur a fee
* If technician is dispatched, travel/mileage fees are non-refundable
* No-show appointments may be billed at full service rate
7. SUPPLY RESPONSIBILITY
β TCF Provides Supplies
(Applies to homebound, concierge, and direct patient services)
β Client/Facility Provides Supplies
(Applies to clinics, labs, and contracted service locations)
Clarification:
* If Client provides lab kits β TCF provides service only
* If TCF provides full service β TCF supplies all necessary materials
8. SAFETY & COMPLIANCE
TCF follows strict protocols including:
* Infection control and PPE usage
* Proper specimen handling and labeling
* Chain-of-custody procedures (when applicable)
TCF reserves the right to refuse service if conditions are unsafe.
9. LIABILITY LIMITATION
TCF is not responsible for:
* Delays caused by third-party laboratories
* Incomplete or incorrect lab orders provided by Client
* Patient non-compliance or refusal
Client agrees to hold TCF harmless except in cases of proven negligence.
10. INDEPENDENT CONTRACTOR STATUS
TCF operates as an independent contractor and is not an employee, partner, or agent of the Client.
11. NON-CIRCUMVENT / NON-COMPETE (LIMITED)
Client agrees not to bypass TCF to directly engage its staff or services introduced through TCF for a period of 12 months, unless agreed in writing.
#12. TERM & TERMINATION
* Agreement remains active until terminated by either party
* Either party may terminate with written notice (7β30 days)
* Outstanding balances must be paid immediately upon termination
13. ENTIRE AGREEMENT
This Agreement represents the full understanding between both parties and may only be modified in writing.
AUTHORIZED SIGNATURES
TCF Lab Service LLC
Signature: _______________________________
Name: Evelina Kissentaner
Date: __________________
Client / Facility
Signature: _______________________________
Name: __________________________________
Title: __________________________________
Date: __________________
