MEMORANDUM of UNDERSTANDING AND ENGAGEMENT AGREEMENT

This Agreement is between Harvest Interventions - William J. Lawless, B.S., CIP, CRS , a
Certified Intervention Professional and Certified Recovery Specialist (sometimes referred to as Bill or
Interventionist) and
_____________________________________________________, (Responsible Party), for the
to provide interventionist services to ________________________________ (Patient) and Patients
family.
The purpose and goal of the intervention process is to educate the patient who is abusing drugs
and/or alcohol and the patients family concerning the need for and availability of in-patient clinical
treatment programs and ultimately for the patient to be admitted voluntarily for treatment.
After initial consultation and determination that the patient is a candidate for
professional inpatient treatment and that intervention is an appropriate, Responsible Party will schedule
with Interventionist the date for the patient intervention the meeting between the Interventionist and the
Patients family (or those who are closest to the patient), generally not exceeding eight participants. All
participants shall be approved by Interventionist prior to invitation and will be required to meet with
Interventionist to confirm suitability for participation. Prior to the intervention, Interventionist will
prepare and instruct the participants individually and as a group. (On occasion, a second group
meeting/rehearsal may be necessary.) All participants must agree to cooperate with the instructions of
the Interventionist.
Responsible Party shall be arrange for the Patient present for the intervention. Interventionist
does not guarantee and payment due under this Agreement is not conditioned upon the Patients
participation.
A successful outcome to the intervention will result in the patient being transported to the
treatment facility where the process of intake, assessment, possible detoxification and a treatment
regimen will begin. However, treatment cannot be forced; the patients admission to treatment is
conditioned upon the patients agreement. If patient is admitted, and with patients written consent,
Interventionist will provide the Responsible Party or other designated family representative with weekly
updates concerning the patients progress during in-patient treatment.
A successful outcome is not guaranteed. The intervention process itself is not a treatment plan, a
cure for addiction, a counseling service, or individual or family/group therapy.
Payment for Interventionists services shall be made in the full non-refundable amount of
$__________________ in advance, upon execution of this Agreement. Costs (e.g. travel, long distance
phone charges, lodging) shall be paid upon invoice. If additional services are requested after the initial
intervention (not exceeding 12 hours) other than weekly updates of progress, and Interventionist agrees
to continue to provide additional services, Responsible Party shall pay for all Costs and for services at
the rate of $___________ per hour.

Responsible Party understands that Interventionist will incur various costs in performing
services under this agreement. The costs commonly include: long distance telephone calls, postage,
reproduction costs, parking, transportation (airfare, mileage, train or bus costs), meals, lodging and all
other costs of any necessary travel photocopy. All costs are charged at actual cost , using the Federal
rate of mileage reimbursement, where applicable (with no mark-up). Where possible, Responsible Party
shall pay costs in advance, but if paid by Interventionist, reimbursement shall be made to Interventionist
promptly upon invoice.
All fees and costs due, payable and paid to Interventionist are non-refundable.
Interventionist does not provide or pay for the costs of Patients treatment; payment for the cost
of treatment is the responsibility of the Patient, or Patients family, or other interested parties.
Responsible Party hereby releases Interventionist, his heirs, legal representatives, successors and assigns
and shall defend and indemnify and hold harmless Interventionist against and with respect to any claims,
actions, demands, losses, costs, expenses, liabilities (joint or several), penalties and damages, including
counsel fees incurred in investigating or in attempting to avoid or oppose the imposition of damages for
any liabilities in connection with Interventionists services pursuant to this agreement and Responsible
Party shall pay all costs and expenses of any litigation, including all counsel fees in connection with the
litigation.
This Agreement shall be governed by and construed in accordance with the laws of the
Commonwealth of Pennsylvania without regard to its conflict of laws provisions. The parties agree that
any dispute or action concerning or arising out of or in any way related to this agreement shall be filed in
the Court of Common Pleas of Northampton County, Pennsylvania, provided that no action shall be filed
against Interventionist except after notice to Interventionist and, at the request of Intervention the
dispute has been submitted for mediation, the mediator to be selected by the parties through the
Pennsylvania Academy of Mediators and Arbitrators, the costs thereof to be shared equally by the
parties, the parties to cooperate fully with the mediation process.
Intending to be legally bound, the parties, executing below, hereby bind themselfs, their heirs,
executors and legal representatives.
____________________________________
William J. Lawless, Interventionist
Harvest Interventions
2812 Santee Drive
Bethlehem, PA 18017
Tel:

____________
Date

_____________________________________
Responsible Party

____________
Date

_____________________________________
Name
_____________________________________
Street Address
_____________________________________
City, State, Zip Code
_____________________________________
Tel: