1099 Contract
Independent Contractor Agreement
Review the complete 1099 Independent Contractor Agreement below. This document outlines the terms, responsibilities, compensation structure, and legal provisions for all pre-licensed clinicians joining our practice.
Important Legal Notice
This contract template is provided for informational purposes only and should be reviewed by a qualified attorney before use. Employment classification (1099 vs. W-2) is governed by federal and state law. Some states may restrict or prohibit pre-licensed clinicians from working as independent contractors. Consult with legal counsel to ensure compliance with all applicable regulations in your jurisdiction.
Agreement Terms
This Independent Contractor Agreement ("Agreement") is made and entered into as of [Date], by and between Supervision Central & Counseling Services (SCCS) ("Practice"), located in Virginia, and [Contractor Name] ("Contractor"), located at [Contractor Address].
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first written above.
Supervision Central & Counseling Services
Authorized Signature & Date
[Contractor Name]
Contractor Signature & Date
Additional Required Forms
In addition to the Independent Contractor Agreement, the following forms and documents are required as part of the onboarding process.
IRS Form W-9
Request for Taxpayer Identification Number — required for all 1099 contractors
Business Associate Agreement (BAA)
HIPAA-required agreement for handling Protected Health Information
Supervision Agreement
Detailed terms of the clinical supervision arrangement
Practice Policies Acknowledgment
Acknowledgment of all practice policies and procedures
Emergency Contact Form
Emergency contact information for the contractor
Background Check Authorization
Authorization for criminal background check
Questions About the Contract?
If you have questions about the agreement terms, please reach out before submitting your application.