Speaker Form


To become a speaker on the Empowering Physician Advisors Show, please fill out the form below and click Send. To obtain a hard copy of this agreement, you may request it via our Contact Us form.

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Date of this Agreement: July 17, 2024

This Intellectual Property Release Agreement (hereinafter referred to as “Release”), effective as of the date above, is made by and between Aerolib Ventures and Speaker, whereas Aerolib Ventures LLC owns and operates the show Empowering Physician Advisor Show which centres around disease specific education with discussions about regulations, compliance, auditing appeals, CERT-RAC-ZPIC news, CDI, use of telemedicine and federal updates. Whereas if the speaker on the show EPAS (Empowering Physician Advisors Show on Physicianonline.org), the Speaker is willing and able to relinquish absolute right, title and interest in the materials and presentations on the show and to Aerolib Ventures LLC.

Speaker hereby grants Aerolib Ventures LLC unconditional and exclusive rights to use, reproduce, prepare derivative works, perform and/or display presentation and materials in their EPAS (Empowering Physician Advisors Show on Physicianonline.org) by executing this waiver and consent form. This right is granted in perpetuity and Speaker agrees that Aerolib Ventures LLC or its subsidiaries will owe no part of the subscription monies to Speaker. Speaker represents and warrants that they are sole holder of copyright and distribution rights from the presentation and materials used and that no other individual or entity may claim any right, title and/or interest in the said material.

The speaker has all the necessary rights to grant enter into this agreement. The Speaker agrees to indemnify and hold harmless the Company, its officers, staff and agents working on its behalf, from any and all claims, actions, suits, costs, damages, and liabilities resulting from any breech of this copyright and speaker permission violations. This agreement may be executed in multiple counterparts, each of which, when executed and delivered, shall be deemed an original, but all of which shall together constitute one and the same instrument.

This agreement will be governed by and interpreted and construed in accordance with the laws of Texas, USA without regard to conflict of laws principles thereof. Speaker represents and warrants that Speaker has read this agreement and understands that this is an important legal document. Speaker hereby represents and warrants that they has been advised of its right to seek independent legal counsel in connection with the execution of this agreement and that Speaker has either retained and has been represented by such legal counsel or has knowingly and voluntarily waived its right to such legal counsel and desires to enter into this agreement with the benefit of independent legal representation.

IN WITNESS WHEREOF, the parties hereto, intending to be legally bound, have caused this agreement to be duly executed as of the day and year first hereinabove written.



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