EXHIBIT 10.2

August 15, 2003

Bank of America, N.A.,
   as Administrative Agent
231 South LaSalle Street
Mail Code: IL1-231-08-03
Chicago,IL 60604
Attn: Kristine Thennes

Re:   Request for Waiver and Amendment of Certain Provisions of the Fifth
Amended
        and Restated Loan Agreement.

Prime Medical Services, Inc., a Delaware corporation (“Company”), certain
Lenders (the “Lenders”), and Bank of America, N.A., as Administrative Agent for
those Lenders (“Administrative Agent”), have entered into that certain Fifth
Amended and Restated Loan Agreement (as renewed, extended, restated, and amended
from time to time, the “Loan Agreement”) dated as of July 26, 2002. Under the
terms of certain Guaranties (for each Guarantor defined below, the “Guaranty”),
certain of the “Subsidiaries” (as defined in the Loan Agreement) of Company
(collectively, the “Guarantors”) have guaranteed payment of the “Guaranteed
Indebtedness” (as defined in the Guaranty). Unless otherwise specified
(i) capitalized terms used herein shall have the same meanings as set forth in
the Loan Agreement and (ii) references to “Sections” are to sections of the Loan
Agreement. Company hereby requests a waiver of certain terms and provisions of
the Loan Agreement and amendments to certain other terms and provisions thereof,
and Company, Lenders, and Administrative Agent have agreed to waive and amend
certain provisions of the Loan Agreement, each subject to the terms and
conditions contained herein.

Section 1.      Company Request. Company has formed a Wholly-Owned Subsidiary of
the Company for the purpose of acquiring Aluminum Body Corporation, a California
corporation (the “Aluminum Body Acquisition”). In connection with the Aluminum
Body Acquisition, Company assumed the obligations of Aluminum Body Corporation
under a guaranty of a letter of credit (the “LC Guaranty”). Certain assets
acquired by Company in the Aluminum Body Acquisition were subject to existing
liens (the “Aluminum Liens”). As a result of the Aluminum Body Acquisition, the
LC Guaranty, and the Aluminum Liens, Company is not in compliance with (a)
Paragraphs (e), (f), and (g) of the definition of Permitted Acquisition, (b) the
prohibition on additional Liens set forth in Section 8.01 of the Credit
Agreement, and (c) the prohibition on additional Debt set forth in Section 8.03
of the Credit Agreement (the violations referenced in subclauses (a) through (c)
of this Section 1 are collectively, the “Covenant Violations”). Company has
requested that Lenders waive any Default or Event of Default resulting from the
Covenant Violations. Company has also requested that certain provisions of the
Loan Agreement be amended.

                         Company has also advised Lenders that it has formed a
Subsidiary (“Merger Sub”) into which Winemiller Communications, Inc., a
Pennsylvania corporation, was merged resulting in a Wholly-Owned Subsidiary of
the Company (the “Winemiller Acquisition”).

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August 15, 2003
Page 2

Section 2.     Waiver. By execution of this Waiver and Amendment, each Lender
executing this Waiver and Amendment (collectively, "Consenting Lenders"),
subject to the terms and conditions included herein, hereby:

  A.

Waives the existence of the Covenant Violations and the Default or Event of
Default created thereby;

  B.

Agrees that the Debt represented by the LC Guaranty shall be excluded from the
calculations of the financial covenants set forth in Section 8.11 until 12:00
noon (Dallas, Texas time) on December 30, 2003;

  C.

In connection with the Winemiller Acquisition, the requirement set forth in
Section (i) of the definition of “Permitted Acquisition” that the Administrative
Agent receive pro forma financial statements of the Companies is hereby waived.

  D.

In connection with the Winemiller Acquisition, the Default or Event of Default
created by Company’s failure to satisfy the requirement set forth in Section
7.12 of the Loan Agreement that upon the formation of Merger Sub the Company
must deliver articles of incorporation, bylaws, resolutions and such opinions as
required by Administrative Agent, and cause Merger Sub to execute a Guaranty,
Guarantor Security Agreement and Pledge Agreement is hereby waived.

Section 3.     Amendments to the Loan Agreement. By execution of this Waiver and
Amendment, the parties hereto have agreed to amend the Loan Agreement as
follows:

           A.       Section 1.01 is hereby amended to amend the definition of
“Permitted Acquisition” to add the
following provisions at the end of such definition:

             (s)        the aggregate cash and assumption of Debt consideration
of such Acquisition does not exceed three (3) times the EBITDA of the Target,
subject to adjustments acceptable to the Administrative Agent where less than
all of the business, assets or stock of the Target is acquired, for the four (4)
fiscal quarters ending on the most recently ended fiscal period prior to the
date of such Acquisition; and

             (t)        less than (i) ten percent (10%) of the assets of the
Target are located outside the United States and (ii) ten percent (10%) of the
Target’s revenues are derived from operations outside of the United States.

           Provided however, that, notwithstanding the foregoing, at any time in
which Borrower’s Total Net Funded Debt to Adjusted EBITDA is greater than 3.0 to
1.0, Borrower may not make any Acquisitions other than Permitted Acquisitions in
which the total consideration for all such Acquisitions is less than $2,000,000
in the aggregate in any twelve (12) month period.

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August 15, 2003
Page 3

           B.       Section 1.01 is hereby amended to delete the grid included
in the definition of “Applicable Margin”
in its entirety and replace such grid with the following:

 
                                         

Total Net Funded Debt to
Adjusted EBITDA Ratio             
 
Less than 2.0 to 1.0
 
Less than 2.50 to 1.0 but greater
than or equal to 2.00 to 1.0
 
Less than 3.00 to 1.0 but greater
than or equal to 2.50 to 1.0
 
Less than 3.50 to 1.0 but greater
than or equal to 3.00 to 1.0
 
Greater than or equal to 3.50 to 1.0
   
                          
Applicable Margin:
Base Rate
Borrowings   
 
0.50%
 

1.00%
 

1.50%
 

2.00%

2.50%
   

Applicable Margin:
Eurodollar Rate
Borrowings   
 
2.00%
 

2.50%
 

3.00%
 

3.50%
 
4.00%
   

Applicable
Margin:
Commitment Fee   
 
0.375%
 

0.50%
 

0.50%

0.625%
 
0.625%
 

           C.       Section 8.11(a) is hereby deleted in its entirety and
replaced with the following:

           (a)        Total Net Funded Debt to Adjusted EBITDA. Borrower will
not permit the Total Net Funded Debt to Adjusted EBITDA Ratio, determined as of
the last day of each fiscal quarter of the Companies and for the four (4) fiscal
quarter period then ending, to exceed the ratio set forth opposite such period
below:

Period
 
July 1, 2003 through September 29, 2003
 
September 30, 2003 through December 30, 2003
 
December 31, 2003 through June 29, 2004
 
June 30, 2004 through December 30, 2004
 
December 31, 2004 and thereafter
   
Ratio
 
4.50 to 1.0
 
4.10 to 1.0
 
3.90 to 1.0
 
3.75 to 1.0
 
3.50 to 1.0
 

 

           Provided however, that if, as of the last date of any reporting
period listed above, Borrower’s Total Net Funded Debt to Adjusted EBITDA Ratio
is equal to or less than 3.0 to 1.0, then Borrower will not permit the Total Net
Funded Debt to Adjusted EBITDA Ratio, determined as of the last day of each
fiscal quarter of the Companies and for the four (4) fiscal quarter period then
ending, commencing with the first fiscal quarter immediately following the
quarter in which Total Net Funded Debt to Adjusted EBITDA Ratio was equal to or
less than 3.0 to 1.0, to exceed the ratio set forth opposite such period below:

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August 15, 2003
Page 4

   
Period
 
July 1, 2003 through June 30, 2004
 
July 1, 2004 and thereafter
   
Ratio
 
3.25 to 1.0
 
3.00 to 1.0
 

Section 4.     Representations. The Company and each Guarantor hereby represent
and warrant to Administrative Agent and the Lenders that: (i) the
representations and warranties contained in the Loan Agreement and the other
Loan Documents are true and correct on and as of the date hereof as though made
on and as of such date; (ii) after giving effect to this letter and the waiver
granted herein, neither the Company nor any of the Guarantors is in default in
the due performance of any covenant or agreement contained in the Loan Agreement
or any other Loan Document; and (iii) after giving effect to this letter and the
waiver granted herein, no Default has occurred and is continuing.

Section 5.     Confirmations. Each of the Company and the Guarantors ratifies
and confirms that the Loan Agreement, the Guaranties, the Borrower Security
Agreement, the Guarantor Security Agreements, the Pledge Agreements, and the
other Loan Documents are and remain in full force and effect in accordance with
their respective terms, as amended hereby. In addition, each of the Guarantors
acknowledges, agrees, accepts and consents to the terms and provisions hereof
and each other Loan Document as amended hereby. Except as expressly provided
herein, this letter does not constitute a waiver or modification of any of the
terms or provisions set forth in the Loan Agreement or any other Loan Document
and shall not impair any right that Administrative Agent or the Lenders may now
or hereafter have under or in connection with the Loan Agreement or any other
Loan Document.

Section 6.     No Impairment. The waivers hereby granted by Administrative Agent
and the Required Lenders (i) does not impair Administrative Agent’s or any of
the Lenders’ rights to insist upon strict compliance with the Loan Agreement or
the other Loan Documents, and (ii) does not extend to any other Loan Document.
The Loan Documents, as waived hereby continue to bind and inure to
Administrative Agent, the Lenders, Company, the Guarantors, and their respective
successors and permitted assigns.

Section 7.      Conditions Precedent. The effectiveness of this letter and
waiver agreement is subject to the conditions precedent that the Administrative
Agent shall have received all of the following, in form and substance
satisfactory to the Administrative Agent:

  A.

No Default. No Default other than the Covenant Violation shall have occurred and
be continuing under the Loan Agreement.

  B.

Representations and Warranties. All of the representations and warranties
contained in Article VII of the Loan Agreement hereof and in each of the other
Loan Documents shall be true and correct on and as of the date hereof with the
same force and effect as if such representations and warranties had been made on
and as of such date, except to the extent that such representations and
warranties speak to a specific date or the facts on which such representations
and warranties are based have been changed by transactions contemplated by the
Loan Documents.

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August 15, 2003
Page 5

  C.

Fees and Expenses. Payment (i) to each Lender executing a counterpart of this
Agreement of a fee equal to its Commitment on the date hereof, multiplied by 20
basis points and (ii) of all fees and expenses of counsel for Administrative
Agent in connection with the preparation and negotiation of this Amendment and
Waiver.

  D.

Updating Certificate. A Certificate signed by the Chief Executive or Chief
Financial Officer or Vice President-Treasurer of Company and the Guarantors
setting forth any changes to the Schedules to the Loan Agreement since the date
of execution of the Loan Agreement.

  E.

Permitted Acquisition Certificate. A duly executed and completed Permitted
Acquisition Certificate substantially in the form of Exhibit I to the Loan
Agreement with appropriate revisions to give effect to the waivers set forth
herein.

  F.

Collateral Documents. Guaranties, Guarantor Security Agreements, and Pledge
Agreements, executed and delivered by Winemiller Communications, Inc. and the
Company, blank stock powers, and other documents reasonably requested by
Administrative Agent, including Articles of Incorporation duly certified by the
Secretary of State of California, by-laws, and board of directors resolutions of
Winemiller Communications, Inc.

Section 8.     Counterparts. This agreement, when countersigned by Company,
Guarantors, Administrative Agent, and Required Lenders shall be a “Loan
Document” as defined and referred to in the Loan Agreement and the other Loan
Documents and may be signed in any number of counterparts, each of which shall
be deemed an original, but all of which together shall constitute one and the
same instrument. This agreement shall be governed by and construed in accordance
with the laws of the State of Texas.

Section 9.     Entire Agreement. THIS AGREEMENT, THE LOAN AGREEMENT, THE NOTES
AND THE OTHER LOAN DOCUMENTS EMBODY THE FINAL, ENTIRE AGREEMENT AMONG THE
PARTIES HERETO AND SUPERSEDE ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS,
REPRESENTATIONS, AND UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THE
SUBJECT MATTER HEREOF AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE OF
PRIOR, CONTEMPORANEOUS, OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OF THE
PARTIES HERETO. THERE ARE NO ORAL AGREEMENTS AMONG THE PARTIES HERETO.

[REMAINDER OF PAGE INTENTIONALLY BLANK.
SIGNATURE PAGES FOLLOW.]

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If the foregoing is agreeable to you, please signify your acceptance of the
terms and conditions set forth herein by placing your signature in the space
provided below.

  Very truly yours,

PRIME MEDICAL SERVICES, INC.,
   as Company

By: _______________________________
       Name: __________________________
       Title:   __________________________

Signature Page to Amendment and Waiver Letter

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  GUARANTORS:

PROSTATHERAPIES, INC.
LITHOTRIPTORS, INC.
FASTSTART, INC.
NATIONAL LITHOTRIPTORS ASSOCIATION
R.R. LITHO, INC.
OHIO LITHO, INC.
MEDTECH INVESTMENT, INC.
PRIME MEDICAL OPERATING, INC.
PRIME MANAGEMENT, INC.
PRIME LITHOTRIPTER OPERATIONS, INC.
PRIME DIAGNOSTIC SERVICES, INC.
PRIME LITHOTRIPSY SERVICES, INC.
PRIME DIAGNOSTIC CORP. OF FLORIDA
SUN MEDICAL TECHNOLOGIES, INC.
PRIME PRACTICE MANAGEMENT, INC.
PRIME SERVICE CENTER, INC.
         formerly known as Prime Cardiac Rehabilitation
         Services, Inc.
ALABAMA RENAL STONE INSTITUTE, INC.
PRIME KIDNEY STONE TREATMENT, INC.
SUN ACQUISITION, INC.
EXECUTIVE MEDICAL ENTERPRISES, INC.
PRIME RVC, INC.
AK ASSOCIATES, L.L.C.
PRIME MEDICAL MANUFACTURING, LLC
PRIME REFRACTIVE MANAGEMENT, L.L.C.
ALUMINUM BODY CORPORATION
WINEMILLER COMMUNICATIONS, INC.
   each as a Guarantor

By: _____________________________________
      Name: ________________________________
      Title:   ________________________________

PRIME MEDICAL MANAGEMENT, L.P.
  as a Guarantor

By: PRIME MEDICAL OPERATING, INC.,
       a Delaware corporation, its General Partner

     By:   __________________________________
             Name: _____________________________
             Title: ______________________________

Signature Page to Amendment and Waiver Letter

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AGREED AND ACCEPTED as of the date first stated above.

  BANK OF AMERICA, N.A., as Administrative Agent

By: _____________________________
          Anne M. Zeschke
          Vice President

Signature Page to Amendment and Waiver Letter

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BANK OF AMERICA, N.A., as a Lender

By: _____________________________
          Daniel H. Penkar
          Senior Vice President

Signature Page to Amendment and Waiver Letter

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  BANK ONE, NA, with its main office in Chicago, Illinois
as a Lender

By: __________________________________
       Name: _____________________________
       Title:   _____________________________

Signature Page to Amendment and Waiver Letter

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  LASALLE BANK, NATIONAL ASSOCIATION,
as a Lender

By: __________________________________
       Name: _____________________________
       Title:   _____________________________

Signature Page to Amendment and Waiver Letter

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  COMERICA BANK,
as a Lender

By: __________________________________
       Name: _____________________________
       Title:   _____________________________

Signature Page to Amendment and Waiver Letter