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                                                               EXHIBIT 10.9
                                                               GRANT NO. _______

                           IMPAC MEDICAL SYSTEMS, INC.

                                 2002 STOCK PLAN

                        INCENTIVE STOCK OPTION AGREEMENT

         IMPAC Medical Systems, Inc. (the "Company"), hereby grants an Option to
purchase shares of its common stock (the "Shares") to the Optionee named below.
The terms and conditions of the Option are set forth in this cover sheet, in the
attachment and in the Company's 2002 Stock Plan (the "Plan").

Date of Option Grant:  __________________, 200__

Name of Optionee:  _________________________________________________

Number of Shares Covered by Option:  ______________

Exercise Price per Share:  $_____.___

Total Exercise Price:  $_____.___

Vesting Start Date:  _____________, 200__

Vesting Schedule:

         Subject to all the terms of the attached Agreement, your right to
purchase Shares under this Option vests as to one-fourth (1/4) of the total
number of Shares covered by this Option, as shown above, on the one-year
anniversary of the Vesting Start Date. Thereafter, the number of Shares which
you may purchase under this Option shall vest at the rate of one-forty-eighth
(1/48) per month on the 1st day of each of the thirty-six (36) months following
the month of the one-year anniversary of the Vesting Start Date. The resulting
aggregate number of vested Shares will be rounded to the nearest whole number.
No additional Shares will vest after your Service has terminated for any reason.

         By signing this cover sheet, you agree to all of the terms and
conditions described in the attached Agreement and in the Plan, a copy of which
is also enclosed.

Optionee:
            ________________________________________________
                                (Signature)

Company:
            ________________________________________________
                                (Signature)

            Title: _________________________________________


Attachment
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                          IMPACT MEDICAL SYSTEMS, INC.

                                 2002 STOCK PLAN

                        INCENTIVE STOCK OPTION AGREEMENT

The Plan and                      The text of the Plan is incorporated in this
Other Agreements                  Agreement by reference. Certain capitalized
                                  terms used in this Agreement are defined in
                                  the Plan.

                                  This Agreement and the Plan constitute
                                  the entire understanding between you
                                  and the Company regarding this Option.
                                  Any prior agreements, commitments or
                                  negotiations concerning this Option are
                                  superseded.

Incentive Stock Option            This Option is intended to be an Incentive
                                  Stock Option under section 422 of the Internal
                                  Revenue Code and will be interpreted
                                  accordingly. If you cease to be an employee of
                                  the Company, a Subsidiary or of a Parent but
                                  continue to provide Service, this Option will
                                  be deemed a Nonstatutory Stock Option on the
                                  90th day after you cease to be an employee. In
                                  addition, to the extent that all or part of
                                  this Option exceeds the $100,000 rule of
                                  section 422(d) of the Code, this Option or the
                                  lesser excess part will be treated as a
                                  Nonstatutory Stock Option.

Vesting                           This Option is only exercisable before it
                                  expires and then only with respect to the
                                  vested portion of the Option. This Option will
                                  vest according to the Vesting Schedule on the
                                  attached cover sheet.

Term                              Your Option will expire in any event at
                                  the close of business at Company
                                  headquarters on the day before the 10th
                                  anniversary of the Date of Option
                                  Grant, as shown on the cover sheet.
                                  Your Option will expire earlier if your
                                  Service terminates, as described below.

Regular Termination               If your Service terminates for any reason,
                                  other than death, Disability or Cause, as
                                  defined below, then your Option will expire at
                                  the close of business at Company headquarters
                                  on the 90th day after your termination date.

Termination for Cause             If your Service is terminated for Cause, as
                                  determined by the Board in its Cause sole
                                  discretion, then you shall immediately forfeit
                                  all rights to your Option and the Option shall
                                  immediately expire. For purposes of this
                                  Agreement, "Cause" shall mean the termination
                                  of your Service due to your commission of any
                                  act of fraud, embezzlement or dishonesty; any
                                  unauthorized use

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                                  or disclosure of confidential information
                                  or trade secrets of the Company (or any
                                  Parent, Subsidiary or Affiliate); or
                                  any other intentional misconduct
                                  adversely affecting the business or
                                  affairs of the Company (or any Parent,
                                  Subsidiary or Affiliate) in a material
                                  manner. This definition shall not
                                  restrict in any way the Company's or
                                  any Parent's, Subsidiary's or
                                  Affiliate's right to discharge you for
                                  any other reason, nor shall this
                                  definition be deemed to be inclusive of
                                  all the acts or omissions which
                                  constitute "cause" for purposes other
                                  than this Agreement.

Death                             If your Service terminates because of
                                  your death, then your Option will
                                  expire at the close of business at
                                  Company headquarters on the date twelve
                                  (12) months after the date of death.
                                  During that twelve (12) month period,
                                  your estate or heirs may exercise the
                                  vested portion of your Option.

Disability                        If your Service terminates because of
                                  your Disability, then your Option will
                                  expire at the close of business at
                                  Company headquarters on the date twelve
                                  (12) months after your termination
                                  date.

Leaves of Absence                 For purposes of this Option, your Service does
                                  not terminate when you go on a bona fide leave
                                  of absence that was approved by the Company in
                                  writing, if the terms of the leave provide for
                                  continued Service crediting, or when continued
                                  Service crediting is required by applicable
                                  law. However, your Service will be treated as
                                  terminating ninety (90) days after you went on
                                  leave, unless your right to return to active
                                  work is guaranteed by law or by a contract.
                                  Your Service terminates in any event when the
                                  approved leave ends unless you immediately
                                  return to active work.

                                  The Company determines which leaves
                                  count for this purpose, and when your
                                  Service terminates for all purposes
                                  under the Plan.

Notice of Exercise                When you wish to exercise this Option, you
                                  must notify the Company by filing the proper
                                  "Notice of Exercise" form at the address given
                                  on the form. Your notice must specify how many
                                  Shares you wish to purchase. Your notice must
                                  also specify how your Shares should be
                                  registered (in your name only or in your and
                                  your spouse's names as community property or
                                  as joint tenants with right of survivorship).
                                  The notice will be effective when it is
                                  received by the Company.

                                  If someone else wants to exercise this
                                  Option after your death,

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                              that person must prove to the Company's
                              satisfaction that he or she is entitled to do so.

Form of Payment               When you submit your notice of exercise, you must
                              include payment of the Exercise Price for the
                              Shares you are purchasing. Payment may be made
                              in one (or a combination) of the following forms:

                              .  Cash, your personal check, a cashier's check, a
                                 money order or an electronic funds transfer.

                              .  Shares which have already been owned by you for
                                 more than six months and which are surrendered
                                 to the Company. The value of the Shares,
                                 determined as of the effective date of the
                                 Option exercise, will be applied to the
                                 Exercise Price.

                              .  To the extent a public market for the Shares
                                 exists as determined by the Company, by
                                 delivery (on a form prescribed by the Company)
                                 of an irrevocable direction to a securities
                                 broker to sell Shares and to deliver all or
                                 part of the sale proceeds to the Company in
                                 payment of the aggregate Exercise Price.

Withholding Taxes             You will not be allowed to exercise this Option
                              unless you make acceptable arrangements to pay any
                              withholding or other taxes that may be due as a
                              result of the Option exercise or sale of Shares
                              acquired under this Option.

Restrictions on Exercise and  By signing this Agreement, you agree not to
Resale                        exercise this Option or sell any Shares acquired
                              under this Option at a time when applicable laws,
                              regulations or Company or underwriter trading
                              policies prohibit exercise, sale or issuance of
                              Shares.  The Company will not permit you to
                              exercise this Option if the issuance of Shares at
                              that time would violate any law or regulation.
                              The Company shall have the right to designate one
                              or more periods of time, each of which shall not
                              exceed one hundred eighty (180) days in length,
                              during which this Option shall not be exercisable
                              if the Company determines (in its sole discretion)
                              that such limitation on exercise could in any way
                              facilitate a lessening of any restriction on
                              transfer pursuant to the Securities Act or any
                              state securities laws with respect to any issuance
                              of securities by the Company, facilitate the
                              registration or qualification of any securities by
                              the Company under the Securities Act or any state
                              securities laws, or facilitate the perfection of
                              any exemption from the registration or
                              qualification requirements of the Securities Act
                              or any applicable state securities laws for the
                              issuance or transfer of

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                              any securities.  Such limitation on exercise shall
                              not alter the vesting schedule set forth in this
                              Agreement other than to limit the periods during
                              which this Option shall be exercisable.

                              If the sale of Shares under the Plan is not
                              registered under the Securities Act, but an
                              exemption is available which requires an
                              investment or other representation, you shall
                              represent and agree at the time of exercise that
                              the Shares being acquired upon exercise of this
                              Option are being acquired for investment, and not
                              with a view to the sale or distribution thereof,
                              and shall make such other representations as are
                              deemed necessary or appropriate by the Company and
                              its counsel.

Transfer of Option            Prior to your death, only you may exercise this
                              Option. You cannot transfer or assign this Option.
                              For instance, you may not sell this Option or use
                              it as security for a loan. If you attempt to do
                              any of these things, this Option will immediately
                              become invalid. You may, however, dispose of this
                              Option in your will.

                              Regardless of any marital property settlement
                              agreement, the Company is not obligated to honor a
                              notice of exercise from your spouse, nor is the
                              Company obligated to recognize your spouse's
                              interest in your Option in any other way.

Retention Rights              Your Option or this Agreement does not give you
                              the right to be retained by the Company (or any
                              Parent or any Subsidiaries or Affiliates) in
                              any capacity. The Company (or any Parent and any
                              Subsidiaries or Affiliates) reserves the right to
                              terminate your Service at any time and for any
                              reason.

Stockholder Rights            You, or your estate or heirs, have no rights as a
                              stockholder of the Company until a certificate for
                              your Option's Shares has been issued. No
                              adjustments are made for dividends or other rights
                              if the applicable record date occurs before your
                              stock certificate is issued, except as described
                              in the Plan.

Adjustments                   In the event of a stock split, a stock dividend or
                              a similar change in the Company stock, the number
                              of Shares covered by this Option and the exercise
                              price per Share may be adjusted (and rounded down
                              to the nearest whole number) pursuant to the Plan.
                              Your Option shall be subject to the terms of the
                              agreement of merger, liquidation or reorganization
                              in the event the Company is subject to such
                              corporate activity.

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Legends                       All certificates representing the Shares issued
                              upon exercise of this Option shall, where
                              applicable, have endorsed thereon the following
                              legends (or such other legend(s) as may be
                              necessary to comply with applicable state or
                              federal securities laws):

                                "THE SHARES REPRESENTED BY THIS CERTIFICATE ARE
                                SUBJECT TO CERTAIN RESTRICTIONS ON TRANSFER AND
                                OPTIONS TO PURCHASE SUCH SHARES SET FORTH IN AN
                                AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED
                                HOLDER, OR HIS OR HER PREDECESSOR IN INTEREST.
                                A COPY OF SUCH AGREEMENT IS ON FILE AT THE
                                PRINCIPAL OFFICE OF THE COMPANY AND WILL BE
                                FURNISHED UPON WRITTEN REQUEST TO THE SECRETARY
                                OF THE COMPANY BY THE HOLDER OF RECORD OF THE
                                SHARES REPRESENTED BY THIS CERTIFICATE."

                                "THE SHARES REPRESENTED HEREBY HAVE NOT BEEN
                                REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
                                AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR
                                OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE
                                REGISTRATION THEREOF UNDER SUCH ACT OR AN
                                OPINION OF COUNSEL, SATISFACTORY TO THE
                                COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION
                                IS NOT REQUIRED."

Applicable Law                This Agreement will be interpreted and enforced
                              under the laws of the State of California.

        By signing the cover sheet of this Agreement, you agree to all of the
        terms and conditions described above and in the Plan.

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