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SottoPelle® Licensing Agreement and Registration Packet Arizona Providers - Tier and Training Selection

SottoPelle® Tier Structure for Arizona Providers

STANDARD TIER	PREMIUM TIER
✓ SottoPelle® Licensing Rights ✓ Enhanced Dosaggio™ Dosing Calculator Access ✓ Orientation Call ✓ Personalized Directory Listing + “Message Me” ✓ Account Management Support ✓ Ongoing Anniversary Calls ✓ MarketSquare Access ✓ Access to Preferred Vendors & Partnerships ✓ Continuing Education Resources ✓ Exclusive Facebook Group ✓ Clinical Support from Certified Trainers ✓ After-Hours Support ✓ Affiliate Program – Caitera™ ✓ Front & Back Office Education ✓ Branding Materials ✓ Social Media Assets ✓ Patient Tool Kit	✓ SottoPelle® Licensing Rights ✓ Enhanced Dosaggio™ Dosing Calculator Access ✓ Orientation Call ✓ Personalized Directory Listing + “Message Me” ✓ Dedicated Account + Technical Manager ✓ Enhanced Monthly Calls ✓ MarketSquare Access ✓ Access to Preferred Vendors & Partnerships ✓ Continuing Education Resources ✓ Exclusive Facebook Group ✓ Clinical Support from Certified Trainers ✓ PRIORITY After-Hours Support ✓ Affiliate Program – Caitera™ ✓ Front & Back Office Education + Dedicated Coordinator ✓ Enhanced Branding Materials ✓ Enhanced Social Media Assets ✓ Enhanced Patient Tool Kit ✓ Exclusive Early Access to New Releases ✓ Exclusive Provider Education Content ✓ Exclusive Patient Education Content ✓ Patient Prospecting Support*
*Premium includes participation in brand-led marketing initiatives. Lead volume or conversion is not guaranteed. Results vary by geography, demand, and provider responsiveness.

STANDARD TIER

PREMIUM TIER

✓ SottoPelle® Licensing Rights
✓ Enhanced Dosaggio™ Dosing Calculator Access
✓ Orientation Call
✓ Personalized Directory Listing + “Message Me”
✓ Account Management Support
✓ Ongoing Anniversary Calls
✓ MarketSquare Access
✓ Access to Preferred Vendors & Partnerships
✓ Continuing Education Resources
✓ Exclusive Facebook Group
✓ Clinical Support from Certified Trainers
✓ After-Hours Support
✓ Affiliate Program – Caitera™
✓ Front & Back Office Education
✓ Branding Materials
✓ Social Media Assets
✓ Patient Tool Kit

✓ SottoPelle® Licensing Rights
✓ Enhanced Dosaggio™ Dosing Calculator Access
✓ Orientation Call
✓ Personalized Directory Listing + “Message Me”
✓ Dedicated Account + Technical Manager
✓ Enhanced Monthly Calls
✓ MarketSquare Access
✓ Access to Preferred Vendors & Partnerships
✓ Continuing Education Resources
✓ Exclusive Facebook Group
✓ Clinical Support from Certified Trainers
✓ PRIORITY After-Hours Support
✓ Affiliate Program – Caitera™
✓ Front & Back Office Education + Dedicated Coordinator
✓ Enhanced Branding Materials
✓ Enhanced Social Media Assets
✓ Enhanced Patient Tool Kit
✓ Exclusive Early Access to New Releases
✓ Exclusive Provider Education Content
✓ Exclusive Patient Education Content
✓ Patient Prospecting Support*

*Premium includes participation in brand-led marketing initiatives. Lead volume or conversion is not guaranteed. Results vary by geography, demand, and provider responsiveness.

Monthly Fee Structure

Pricing Structure
If paying for a full year, a 10% discount will be applied

STANDARD TIER	PREMIUM TIER
$495 + Per Patient Fee $35.00 per female patient insertion $70.00 per male patient insertion	$900 (first provider) $35.00 per female patient insertion $70.00 per male patient insertion
$395 (each additional provider)	$800 (each additional provider)

Please Select Your Tier of Choice:

Starter Tier

Standard Tier

Please review all additional documents below and accept your review - click HERE to review each document:

Full License Agreement can be viewed HERE.

Use of Dosaggio is protected as defined in:

Business Associate Agreement, found HERE
Terms of Service, found HERE

SottoPelle's Website and Advertising Policy can be found HERE.

I confirm that I have been provided all pertinent agreements and policies and will abide by their conditions

Date:

Training Fee Structure

Training costs related information

Training Fees are One-Time Fees
Additional Providers may be eligible for a reduced one time fee, as defined below.
Training providers must be eligible for Mini and Full Refresher Training Courses
- Proof of prior training is required
Support Staff training is provided as part of the licensing fee for standard and premium tiers
Access to MarketSquare by SottoPelle® Online education platform for continuing education is available if the account remains in good standing

ONSITE	VIRTUAL TRAINING	ONLINE
$2,250	$2,250	$1,495
Join us in person at one of our locations. Includes: ✓ Full-day in-person training with hands-on instruction ✓ Clinical dosing education and methodology ✓ Live insertion demonstration ✓ Case Management & evaluation ✓ Certificate of completion upon passing View Upcoming Dates & Locations	Join us virtually for a live Arizona training. Includes: ✓ Full-day in-person training with live instruction ✓ Clinical dosing education and methodology ✓ Live insertion demonstration ✓ Case Management & evaluation ✓ Certificate of completion upon passing	Train at your own pace with our fully digital program. Includes: ✓ Access to online physician training portal ✓ Clinical dosing education and methodology ✓ Dosing review and final case evaluation ✓ Certificate of completion upon passing

MINI REFRESHER ONLINE	FULL REFRESHER ONLINE	OPTIONAL TRANSGENDER PATIENT
$499	$599	$115
Train at your own pace with our fully digital program. Includes: ✓ Access to online physician training portal ✓ Recertification modules ✓ Certificate of completion upon passing	Train at your own pace with our fully digital program. Includes: ✓ Access to online physician training portal ✓ Clinical dosing education and methodology ✓ Dosing review and final case evaluation ✓ Certificate of completion upon passing	Optional online course designed to expand knowledge in transgender patient care. Includes: ✓ Self-paced training module covering treatment of transgender individuals ✓ Certificate of completion ✓ Unlocks additional resources and dosing calculator options Can be added to any training path

Please Select Your Primary Training Program

Onsite Training

Virtual Training

Online Training

Mini Refresher

Full Refresher

Are You Enrolling In The Optional Transgender Patient Training?

Check this box to confirm adding the Transgender Patient Pellet Therapy training course to your training program

Licensing Terms for SottoPelle Standard and Premium Tiers

Summary: Terms and Conditions of the SottoPelle® Master Licensing Agreement

Terms for each pricing structure are effective 6 months from date of joining across all tiers
All tiers are a 12-month fixed committment - 30 days written notice is required for termination.
A provider may upgrade tiers at any time, but may not downgrade inside of the 12 months
SottoPelle® may terminate if practice practitioners lose medical or DEA licenses, are suspended by State or federal programs, fail to abide by Program Guidelines, cannot perform essential duties, etc. This Clause 1.2 is standard and reasonable.
Compliance with Program Guidelines (section 5) for protecting intellectual property. Indemnifications are standard for both licensor and practice.
Governing law is the State of Arizona

I am confirming I have read the licensing terms and opt-out overview

Registration Information

Provider and Practice Information:

Provider Name AND Credentials:

Practice Name:

Provider Email:

Provider Cell Phone Number:

Office Phone Number:

Opt-In for text communications- By checking this box you consent to receive follow up, support, promotional messages and information from SottoPelle® at the number provided. Message and data rates may apply. Reply HELP for help or STOP to cancel.

Are you board certifed in multiple states?

Yes

If yes, which states?

History of malpractice or litigation?

Yes

If yes, please give detail:

*Please provide us with current and valid copies of your Medical License for each state and / or country*

Practice Office Address:

Office Website:

Do You Have Additional Offices?

Yes

If you have additional offices, please indicate location:

Are you the Sole Practitioner?

Yes

How many years have you been practicing at your current location?

Please indicate which patients you'll be treating:

Female Patients

Male Patients

Transgender Patients

Do You Practice or Have Your Ever Practiced Any Method of Hormone Replacement Therapy?

Yes

IF YES, what form or method?

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Signed by CarolAnn Tutera
Signed On: February 9, 2026

Timestamp

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July 29, 2025 8:29 pm MST

SottoPelle® Licensing Agreement and Registration Packet Arizona Providers - Tier and Training Selection Uploaded by Alecia Cullum - acullum@sphrt.com IP 64.38.182.126

July 29, 2025 8:32 pm MST

Document owner response@sphrt.com has handed over this document to acullum@sphrt.com 2025-07-29 20:32:43 - 52.144.111.159