Note/Disclaimer: This draft is a sample text prepared to regulate emergency transport processes of private healthcare institutions under the coordination of 112 Emergency Medical Services . It should be adapted according to the practices of the relevant provincial directorate, current legislation, and the status of the parties (administrative/private legal entity).

1. PARTIES

1.1. Administration: ………………… Provincial Health Directorate (hereinafter referred to as “Provincial Health Directorate” or “Administration”)
Address: ……………………………………………………………………………

1.2. Private Healthcare Institution: A licensed institution (Private Hospital / Private Medical Center / Private Specialty Center / Private Polyclinic) (hereinafter referred to as “ÖSK”) in accordance with the relevant legislation.
Address: ……………………………………………………………………………

The parties will be referred to collectively as "the Parties".

2. BASIS AND LEGAL NATURE

2.1. This Agreement of the Ministry of Health , the Regulation on Ambulances and Emergency Medical Vehicles and Ambulance Services, the Basic Law on Health Services, the Working Procedures and Principles of Provincial Ambulance Services , and other relevant legislation.

2.2. The legal nature of the contract may be a service contract or an administrative contract/protocol subject to private law provisions, depending on the status of the parties . The parties shall also regulate the applicable judicial remedy in Article 21

3. DEFINITIONS

3.1. 112 KKM: Provincial Ambulance Service Command and Control Center . 3.2. Emergency Transfer: Urgent transfer of a patient to an inpatient treatment facility due to life-threatening conditions or urgent medical necessity. 3.3. Inpatient Treatment Facility: Public/private hospitals and other inpatient healthcare facilities authorized by legislation. 3.4. Case Record Form (CRF): All clinical and operational records, including ambulance case form/epicrisis and electronic records. 3.5. Consumables: Disposable medical supplies, medications, and disposable materials for transport equipment. 3.6. SLA (Service Level Indicators): Performance metrics such as response times, delivery rates, appropriate routing, and data completeness.

4. SUBJECT AND SCOPE OF THE AGREEMENT

4.1. The provision of Emergency Ambulance services, coordinated by 112 Emergency Call Center, for the transfer of patients who apply to the Emergency Medical Services and require urgent transport to suitable inpatient treatment facilities within the provincial borders of …

4.2. This service only the primary care facility to an inpatient treatment institution. Transfers to private residences, nursing homes, and outpatient diagnostic/treatment centers are excluded.

4.3. If no available beds are found within the province, or if the 112 Emergency Call Center deems it appropriate for medical/logistical reasons a referral to another province may be made; procedures and costs shall be applied in accordance with Article 11 and Annex-1.

5. EXECUTION OF THE SERVICE

5.1. Call and Activation: The Emergency Medical Service (EMS) calls 112 (112 Emergency Call Center); the call is made by an authorized person/physician , and the preliminary diagnosis, vital signs, and interventions performed are reported. 5.2. Triage and Referral: The institution to which the patient will be transferred is determined by the 112 Emergency Call Center ; clinical suitability, bed/specialty access, and field density are taken into consideration. 5.3. Companion: With medical necessity and the approval of the 112 Emergency Call Center, one companion may be accepted. 5.4. Delivery: Upon patient admission, the patient's medical history/epicrisis and medication/drug list are delivered completely. 5.5. Call Cancellation/Rejection: Calls that have lost their emergency nature, are found to be incorrect/misleading, or do not meet the patient transfer criteria may be cancelled (Article 15).

6. VEHICLE, EQUIPMENT AND MAINTENANCE

6.1. The ambulances used must comply with the type, equipment, and minimum material list stipulated in the relevant regulation (Annex-2). 6.2. Periodic maintenance, calibration , and sterilization records are kept regularly and presented during inspections. 6.3. The backup vehicle/team plan is implemented in coordination with the Provincial Health Directorate to ensure continuity of service

7. PERSONNEL QUALIFICATIONS AND WORKING PROCEDURES

7.1. Ambulance personnel must possess the certificates and competencies required by legislation (paramedic/EMT/driver, etc.). 7.2. The team leader acts according to medical priorities in case management; physician independence and ethical principles are adhered to. 7.3. Personnel lists, certificates, and refresher training are tracked in Appendix 3

8. MEDICAL SUPPLIES, DRUG AND WASTE MANAGEMENT

8.1. Medical supplies and medications to be used in the ambulance are provided by the Emergency Medical Services Directorate (ÖSK); consumption and stock records are kept. 8.2. Medical waste is disposed of in accordance with the Medical Waste Control Legislation and the rules of the local administration. 8.3. Storage and record-keeping responsibilities for products requiring a cold chain belong to the ÖSK

9. RECORDING, REPORTING AND QUALITY

9.1. A complete patient report/epicrisis is prepared for each case; real-time/post-delivery data sharing is ensured with the 112 Emergency Call Center. 9.2. Records are kept for the period stipulated in the legislation. 9.3. SLA Indicators: (i) Initial contact → activation time, (ii) arrival time at the address, (iii) file completeness, (iv) false call rate, (v) patient delivery time, etc. metrics are defined in Appendix 6. 9.4. The Provincial Health Directorate is authorized to conduct audits and request improvements.

10. PRIVACY, GDPR AND DATA PROCESSING

10.1. Personal/data security is ensured in accordance with Law No. 6698 on the Protection of Personal Data and special legislation regarding health data . 10.2. Data processing/transfer must be limited to the purpose , comply with the principles of minimum data and secure storage ; technical/administrative measures must be taken. 10.3. OSK personnel sign a confidentiality agreement ; the Data Processing Undertaking is included in Appendix 4

11. PRICING AND PAYMENT

11.1. The Health and Social Assistance Foundation shall deposit a fixed monthly service fee of …… TL , regardless of whether the patient is transported or not , into the account number … of the Health and Social Assistance Foundation at … Bank … Branch . 11.2. The deposit slip must be submitted to the 112 Emergency Assistance and Rescue Services Branch Directorate no later than the 5th of each month . 11.3. The fee will be updated for the following year according to the Turkish Statistical Institute (TÜİK) CPI (or an index agreed upon by the Parties) rate. 11.4. In case of delay , a default interest of ……… rate will be applied. 11.5. Exceptional expenses such as out-of-province referrals, multiple accompaniments, and special supplies/medications may be billed separately according to Appendix 1 Price Tariff

12. INSTRUCTIONS AND AUTHORITY

12.1. 112 personnel and field teams medical/operational instructions onlyfrom the 112 Emergency Call Center. The to give direct instructions .
12.2. The destination institution and route the 112 Emergency Call Center .

13. AUDIT AND NON-CONFORMITY MANAGEMENT

13.1. The Provincial Health Directorate may conduct on-site/remote inspections of records, equipment, personnel qualifications, and SLA performance. 13.2. In case of non-conformity , a written warning will be issued; if not rectified within … days , penalties (Article 15) and/or termination (Article 18) may be applied.

14. LIABILITIES AND INSURANCE

14.1. The parties are liable for damages arising from their personnel and activities in proportion to their fault .
14.2. Compulsory Motor Vehicle Liability Insurance, Compulsory Passenger Personal Accident Insurance, Employer's Liability Insurance and other appropriate liability/professional liability insurances shall remain in effect.
14.3. Coverage for damages that may be caused to third parties clearly stated in the policies; copies of the policies annually .

15. IMPROPER/FALSE CALLS AND PENALTY CLAUSES

15.1. Calls that do not meet emergency criteria, intentionally provide false/misleading information, or are repeated knowingly are considered "irregular calls" . 15.2. A penalty of … TL per call will be applied for irregular calls; if repeated … times within … months, the contract may be terminated for just cause . 15.3. The Public Service Commission is responsible for any waste of public resources and damages arising from intent/negligence .

16. OCCUPATIONAL HEALTH AND SAFETY

16.1. The parties shall conduct risk assessments , prepare personal protective equipment (PPE) , conduct training , and develop emergency plans within the scope of the Occupational Health and Safety Law No. 6331 and related legislation

17. FORCE MAJEURE

17.1. The obligations of the parties are suspended to the extent that force majeure events such as natural disasters, war, mobilization, general strikes, widespread epidemics, large-scale public order events, etc., are documented . 17.2. If the force majeure event exceeds … days , the parties may choose to terminate the contract

18. TERMINATION

18.1. Either party may exercise the right to terminate the contract with written notice, … months in advance . 18.2. Immediate termination for just cause is possible in the following cases: (a) Failure to remedy violations of legislation, (b) Violation of payment obligations exceeding … days , (c) Repeated unauthorized calls , (d) Violation of GDPR/privacy , (e) Obstruction of audits .

19. DURATION OF THE AGREEMENT

19.1. This agreement enters into force on the date of signature and is valid for a period of … years ; it shall be automatically extended for periods of … years unless terminated (optional).

20. TRANSFER, SUBCONTRACTORS AND REFERENCES

20.1. Contractual rights and obligations the prior written approval of the Provincial Health Directorate ; the use of subcontractors is prohibited/subject to the written approval of the Administration (selected according to the party).
20.2. In case of changes in legislation, Article 22 .

21. RESOLUTION OF DISPUTES (ALTERNATIVE JUDICIAL REMEDIES)

Option A – Judicial Jurisdiction: In disputes arising from this contract , the Enforcement Offices and Courts of … shall have jurisdiction; Turkish Law shall apply. Option B – Administrative Jurisdiction: If the contract is deemed to be of an administrative nature , the Administrative Courts of … shall have jurisdiction in resolving disputes .

The parties must choose a single option when the contract is finalized .

22. AMENDMENT AND INTEGRITY

22.1. The relevant articles shall be automatically adapted in accordance with the provisions of new contracts/circulars to be published by the Ministry of Health/Administration . 22.2. Other changes shall become valid with the written agreement of the Parties. 22.3. This Agreement and its annexes (Annex-1 … Annex-6) constitute a whole

23. NOTIFICATIONS AND COMMUNICATION

23.1. Notifications made to the addresses of the parties specified in the title shall be deemed valid notifications ; notifications made to the old address shall be valid unless a change of address is notified in writing within … days . 23.2. Operational communication channels and the emergency contact list are included in Appendix 5

24. EFFECTIVE DATE

24.1. This Agreement was signed on …/…/20… and enters into force on the same date

25. SIGNATURES

It was prepared in duplicate, with one copy given to each party.

PROVINCIAL HEALTH DIRECTORATE
Name/Surname – Title – Signature – Stamp
Date: …/…/20…

PRIVATE HEALTH INSTITUTION (PHI)
Responsible Manager – Title – Signature – Stamp
Date: …/…/20…

APPENDICES

• Appendix 1: Pricing and Special Expense Items Schedule
• Appendix 2: Ambulance Type, Equipment and Minimum Material List
• Appendix 3: Staff List, Certificates and Training Schedule
• Appendix 4: KVKK – Data Processing and Privacy Commitment
• Appendix 5: Operational Communication, Calling and Escalation Procedure
• Appendix 6: Service Level Indicators (SLAs) and Reporting Formats

Appendix 6: Sample SLA Metrics (Guide)

• Response Time (Within the city): of calls from activation to arrival at the address ≤ 15 minutes.
• File Completeness: 98% of VKF/epicrisis records are complete.
• False/Illegal Call Rate: ≤ 2% (monthly).
• Patient Transfer Time: admission process from arrival at the appropriate hospital is ≤ 15 minutes.
• Resolution of audit irregularities: ≤ 15 days.