EX-10.12





 Exhibit 10.12 

 

			
	 Name: 
	  	 [ ]

	 Number of Restricted Stock Units subject to Award:
	  	 [ ]

	 Date of Grant:
	  	 [ ]


 LIFESTANCE HEALTH GROUP, INC.

 2021 EQUITY INCENTIVE PLAN 

RESTRICTED STOCK UNIT AWARD AGREEMENT 

This agreement (this “Agreement”) evidences an award (the “Award”) of restricted stock units granted by
LifeStance Health Group, Inc. (the “Company”) to the individual named above (the “Participant”), pursuant to and subject to the terms of the Company’s 2021 Equity Incentive Plan (as amended from time to time,
the “Plan”). 
 1. Grant of Restricted Stock Unit Award. The Company grants to the Participant on the date set forth
above (the “Date of Grant”) the number of restricted stock units (the “Restricted Stock Units”) set forth above giving the Participant the conditional right to receive, without payment and pursuant to and subject to
the terms and conditions set forth in this Agreement and in the Plan, one share of Stock (a “Share”) with respect to each Restricted Stock Unit forming part of the Award, subject to adjustment pursuant to Section 7 of the Plan
in respect of transactions occurring after the date hereof. 
 2. Meaning of Certain Terms. Except as otherwise defined herein, all
capitalized terms used herein have the same meaning as in the Plan. 
 3. Vesting; Cessation of Employment. [Omitted] 

4. Delivery of Shares. Subject to Section 5 below, the Company shall, as soon as practicable upon the vesting of any portion of the
Award (but in no event later than thirty (30) days following the date on which such Restricted Stock Units vest), effect delivery of the Shares with respect to such vested Restricted Stock Units to the Participant (or, in the event of the
Participant’s death, to the person to whom the Award has passed by will or the laws of descent and distribution). No Shares will be issued pursuant to the Award unless and until all legal requirements applicable to the issuance or transfer of
such Shares have been complied with to the satisfaction of the Administrator. 
 5. Forfeiture; Recovery of Compensation. The
Administrator may cancel, rescind, withhold or otherwise limit or restrict the Award at any time if the Participant is not in compliance with all applicable provisions of this Agreement and the Plan. By accepting, or being deemed to have accepted,
the Award, the Participant expressly acknowledges and agrees that his or her rights, and those of any permitted transferee of the Award, under the Award, including the right to any Shares acquired under the Award or proceeds from the disposition
thereof, are subject to Section 6(a)(5) of the Plan (including any successor provision). The Participant further agrees to be bound by the terms of any clawback or recoupment policy of the Company that applies to incentive compensation that
includes Awards such as the Restricted Stock Units. Nothing in the preceding sentence may be construed as limiting the general application of Section 10 of this Agreement. 












 6. Dividends; Other Rights. The Award may not be interpreted to bestow upon the
Participant any equity interest or ownership in the Company or any subsidiary prior to the date on which the Company delivers Shares to the Participant. The Participant is not entitled to vote any Shares by reason of the granting of the Award or to
receive or be credited with any dividends declared and payable on any Share prior to the date on which any such Share is delivered to the Participant hereunder. The Participant will have the rights of a shareholder only as to those Shares, if any,
that are actually delivered under the Award. 
 7. Nontransferability. The Award may not be transferred except as expressly permitted
under Section 6(a)(3) of the Plan. 
 8. Taxes. 
  

	 	(a)	 The Participant expressly acknowledges that the vesting or settlement of the Restricted Stock Units acquired
hereunder may give rise to “wages” subject to withholding. No Shares will be delivered pursuant to the Award unless and until the Participant has remitted to the Company in cash or by check (or by such other means as may be acceptable to
the Administrator) an amount sufficient to satisfy all taxes required to be withheld in connection with such vesting or settlement. The Participant authorizes the Company and its subsidiaries to withhold any amounts due in respect of any required
tax withholdings or payments from any amounts otherwise owed to the Participant, but nothing in this sentence may be construed as relieving the Participant of any liability for satisfying his or her obligation under the preceding provisions of this
Section 8. 


  

	 	(b)	 The Award is intended to be exempt from Section 409A of the Code as a short-term deferral thereunder and
shall be construed and administered in accordance with that intent. Notwithstanding the foregoing, in no event will the Company have any liability relating to the failure or alleged failure of any payment or benefit under this Agreement to comply
with, or be exempt from, the requirements of Section 409A. 


 9. Effect on Employment. Neither the grant of the
Award, nor the issuance of Shares upon the vesting of the Award, will give the Participant any right to be retained in the employ or service of the Company or any of its subsidiaries, affect the right of the Company or any of its subsidiaries to
discharge the Participant at any time, or affect any right of the Participant to terminate his or her Employment at any time. 
 10.
Provisions of the Plan. This Agreement is subject in its entirety to the provisions of the Plan, which are incorporated herein by reference. A copy of the Plan as in effect on the Date of Grant has been furnished to the Participant. By
accepting, or being deemed to have accepted, all or any portion of the Award, the Participant agrees to be bound by the terms of the Plan and this Agreement. In the event of any conflict between the terms of this Agreement and the Plan, the terms of
the Plan will control. 
 11. Acknowledgements. The Participant acknowledges and agrees that: 

  
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	 	(a)	 The grant of the Restricted Stock Units is considered a one-time
benefit and does not create a contractual or other right to receive any other award under the Plan, benefits in lieu of such awards or any other benefits in the future. 



 

	 	(b)	 The Plan is a voluntary program of the Company and future awards, if any, will be at the sole discretion of the
Company, including, but not limited to, the timing of any award, the amount of any award, vesting provisions and purchase price, if any. 


  

	 	(c)	 The value of the Restricted Stock Units is an extraordinary item of compensation outside of the scope of the
Participant’s employment. As such, the Restricted Stock Units are not part of normal or expected compensation for purposes of calculating any severance, resignation, redundancy, end of service payments, bonuses, long-term service awards,
pension or retirement benefits or similar payments. 


  

	 	(d)	 The Participant authorizes the Company to use and disclose to any agent administering the Plan or providing
recordkeeping services with respect to the Plan such information and data as the Company shall request in order to facilitate the grant of the Restricted Stock Units, the administration of the Restricted Stock Units and the administration of the
Plan, and the Participant waives any data privacy rights he or she may have with respect to such information or the sharing of such information. 


  

	 	(e)	 (i) This Agreement may be executed in two or more counterparts, each of which will be an original and all of
which together will constitute one and the same instrument, (ii) this Agreement may be executed and exchanged using facsimile, portable document format (PDF) or electronic signature, which, in each case, will constitute an original signature
for all purposes hereunder, and (iii) such signature by the Company will be binding against the Company and will create a legally binding agreement when this Agreement is countersigned by the Participant. 



[Signature page follows.] 

  
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 The Company, by its duly authorized officer, and the Participant have executed this
Agreement as of the Date of Grant. 
  

			
	LIFESTANCE HEALTH GROUP, INC.
		
	By:	 	
                     
               

	Name:	 	  

	Title:	 	  



  

			
	Agreed and Accepted:
		
	By	 	
                     
                                         
  

		 	[Participant’s Name]

 Signature Page to Restricted Stock Unit Award Agreement