Document:

AGREEMENT

                                     Between

                                 IVPCARE, INC.,

                                       And

                            INTEGRAMED AMERICA, INC.

         THIS AGREEMENT ("Agreement"), is dated October 1, 2005 and is made and
entered into by and between ivpcare, Inc., a Texas corporation with its
principal place of business at 7164 Technology Drive, Suite 100, Frisco, Texas
750034 ("IVP"), and IntegraMed America, Inc., a Delaware corporation with its
principal place of business at Two Manhattanville Road, Purchase, New York 10577
("IntegraMed"). IVP and IntegraMed are individually referred to herein as a
"Party" and collectively referred to as "Parties."

                                    RECITALS

         0.1 WHEREAS, IVP is a licenced pharmacy specializing in dispensing
ingestable, injectable, and infusion drugs, pharmaceuticals, and products
related to the treatment of human infertility, pursuant to the prescription of a
duly licensed and authorized physician ("Pharmaceutical Products") to end-user
patients ("Customers");

         0.2 WHEREAS, IntegraMed has developed, and may develop in the future,
relationships, affiliations and associations with certain infertility medical
practices, as set forth on Exhibit 0.2 attached hereto, as may be amended from
time to time (such existing and any future medical practice and associated
infertility medical practices shall hereinafter be referred to collectively as
the "Medical Practices");

         0.3 WHEREAS, IntegraMed arranges for the retail distribution of
Pharmaceutical Products and educational materials to Customers of the Medical
Practices (collectively herein, "Pharmaceutical Services");

         0.4 WHEREAS, IntegraMed will, through a variety of marketing
communications, management, and patient education efforts, introduce Customers
of the Medical Practices to the availability and benefits of the Pharmaceutical
Services it offers (the "Marketing Services") in recognition that on-going
communciations with the Medical Practices will facilitate greater penetration
and utilization of the Pharmaceutical Services by the Customers of the Medical
Practices; it being specifically understood that IntegraMed's efforts shall not
be the sole marketing efforts to the Medical Practices, but shall be in addition
to certain sales efforts made by IVP pursuant to Section 3.1.7; and

<PAGE>

         0.5 WHEREAS, IVP will provide administrative, business, and pharmacy
services as are necessary and appropriate for the provision of Pharmaceutical
Services to Customers of the Medical Practices (the "Services"); and

                  NOW, THEREFORE, in consideration of the foregoing premises and
of the mutual covenants and obligations set forth herein, and for such other
good and valuable consideration the receipt and sufficiency of which are hereby
acknowledged, the parties to this Agreement hereby covenant and agree as
follows:

                                    ARTICLE 1

                                   DEFINITIONS

                  1.1  DEFINITIONS.  For the  purposes  of this  Agreement,  the
following definitions shall apply:

                  1.1.1 "Cost of Operations" shall mean a monthly fee recorded
         by IVP on the last day of each month for the items described in Section
         2.1 below. Cost of Operations shall equal that percentage of the Net
         Sales realized or accrued during the current month as set forth on
         Exhibit 1.1.1 attached hereto, as may be amended from time to time.

                  1.1.2 "Cost of Pharmaceutical Products" shall mean the cost of
         Pharmaceutical Products sold by IVP resulting in Net Sales to Customers
         of Medical Practices and shall equal IVP's wholesale cost for such
         Pharmaceutical Products, as set forth on Exhibit 1.1.2 attached hereto,
         as may be amended from time to time.

                  1.1.3 "Collections" shall mean all payments actually received
         by IVP from the distribution of Pharmaceutical Products to Customers of
         the Medical Practices and the provision of Pharmaceutical Services
         hereunder.

                  1.1.4 "Cycle Kit" shall mean the packaging format and patient
         education materials that IVP supplies to Customers of the Medical
         Practices under the trade name "Cycle Kit(TM)."

                  1.1.5 "Direct Costs" shall mean the cost of outside
         accountants and attorneys who provide services directly related to Net
         Sales.

                  1.1.6 "Employees" shall mean such accounting, nursing,
         pharmacy, secretarial, receptionist, and billing and collections
         personnel necessary for IVP to provide the Services related to Net
         Sales. Such Employees may be employees exclusively of IVP, or may be
         independent contractors or leased employees.

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<PAGE>

                  1.1.7 "Fiscal Year" shall mean the 12-month period beginning
         January 1 and ending December 31 of each year.

                  1.1.8 "GAAP" shall mean generally accepted accounting
         principles applied to public companies in the United States.

                  1.1.9 "Joint Committee" shall mean the committee  described in
         Section 5.1 below.

                  1.1.10 "Month" shall mean a calendar month.

                  1.1.11 "Net Sales" shall mean gross revenues resulting from
         the provision of the Services, by IVP to Customers of the Medical
         Practices, that are earned and recorded in accordance with GAAP less
         contractual sales discounts and bad debt.

                                    ARTICLE 2

                               COST OF OPERATIONS

         2.1 COST OF OPERATIONS. The Cost of Operations reflected on Exhibit
1.1.1 as a pre-determined percentage of Net Sales cover, and fully compensate
IVP for the following costs and expenses with respect to the Net Sales:

                  2.1.1 Salaries, fringe benefits, payroll taxes, and other
         costs of employing or retaining employees to provide the Services, as
         defined in Section 0.7 hereof;

                  2.1.2 Any sales and use taxes assessed  against IVP related to
         provision of the Services ;

                  2.1.3 Professional and regulatory licensure fees;

                  2.1.4  Insurance  premiums  that are paid with  respect to the
         insurance delineated in Article 11 below.

                  2.1.5 Such other costs and expenses  actually  incurred by IVP
         reasonably necessary for the provision of the Services.

         2.2 In addition to the Cost of Operations provided for in Section 2.1,
IVP shall be entitled to an interest expense cost, with respect to its accounts
receivables resulting from Net Sales, at a rate equal to LIBOR plus 2.25%,
adjusted monthly based on the LIBOR for the applicable month.

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<PAGE>

         2.3 Notwithstanding anything to the contrary contained herein, Cost of
Operations shall not include the following:

                  2.3.1 Direct Costs;

                  2.3.2 The Marketing Services Fee;

                  2.3.3 Any federal or state  income or  franchise  taxes of IVP
         related to Net Sales; or

                  2.3.4 Cost of Pharmaceutical Products.

                                    ARTICLE 3

                       DUTIES AND RESPONSIBILITIES OF IVP

         3.1 SERVICES AND ADMINISTRATION. IVP agrees to record and account
separately for Net Sales and agrees that the Services delineated in this Section
3.1, all of which shall be fully compensated by and included in the Cost of
Operations and applicable Sales Support Fee.

                  3.1.1 IntegraMed hereby appoints IVP as IntegraMed's sole and
         exclusive agent and administrator to distribute Pharmaceutical Products
         to Customers of the Medical Practices and grants IVP all the necessary
         authority to carry out its duties and responsibilities pursuant to the
         terms of this Agreement.

                  3.1.2 IVP shall bill Customers and collect fees for
         Pharmaceutical Products supplied to Customers of the Medical Practices.

                  3.1.3 IVP shall maintain all files and records relating to
         accounting and billing records, and collection records with respect to
         the Net Sales. Prescription records shall at all times be and remain
         the property of IVP. IVP's maintenance of all files and records shall
         comply with all applicable state and federal laws and regulations,
         including, without limitation, those pertaining to confidentiality of
         patient records. The records relating to Customers of the Medical
         Practices shall be expressly deemed confidential and shall not be made
         available to any third party except in compliance with all applicable
         laws, rules, and regulations. IVP may utilize such records in order to
         provide the Services hereunder, to perform billing functions, and to
         prepare for the defense of any lawsuit in which those records may be
         relevant. The obligation to maintain the confidentiality of such
         records shall survive termination of this Agreement. IntegraMed,
         subject to applicable HIPAA regulations and State privacy laws, shall
         have unrestricted access to all of such records at all times and such

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<PAGE>

         right shall survive any termination of this Agreement. In connection
         therewith, IntegraMed agrees to enter into IVP's standard Business
         Associate Agreement required under HIPAA.

                  3.1.4 IVP shall maintain all reasonably necessary management,
         administrative, supervisory, nursing, pharmacy, clerical, accounting
         and bookkeeping employees necessary to provide, and IVP shall provide,
         quality and competent Pharmaceutical Services to Customers of the
         Medical Practices. IVP shall provide such computer services, printing,
         postage and duplication services, and any other necessary or
         appropriate administrative services reasonably necessary for the
         provision of Pharmaceutical Services to Customers of the Medical
         Practices. IVP shall have the responsibility for hiring, supervising,
         promoting, reprimanding, suspending, and/or reinstating and terminating
         its employees consistent with IVP's policies and procedures.

                  3.1.5 IVP shall arrange for such legal and accounting services
         as may be reasonably required in the ordinary course of providing the
         Pharmaceutical Services; provided, however, that IVP shall have no
         authority to arrange for any legal or accounting services on behalf of
         IntegraMed. IVP will maintain all bookkeeping services necessary to
         support the Pharmaceutical Services made available to Customers of the
         Medical Practices, including, without limitation, maintenance, custody,
         and supervision of all business records, papers, documents, ledgers,
         journals and reports, and the preparation, distribution, and
         recordation of all bills and statements for services rendered by IVP,
         including the billing and completion of reports and forms required by
         insurance companies, governmental agencies, or other third-party
         payors.

                  3.1.6 IVP shall remit to IntegraMed monthly the IntegraMed
         Marketing Services Fee provided for in Article 6 hereof.

                  3.1.7 In connection with any Pharmaceutical Products sold to
         Customers of the Medical Practices, IVP shall provide CycleTriage,
         CycleTrack, CycleKits and any patient educational materials in the same
         manner as it provides such to Customers purchasing Pharmaceutical
         Products directly from IVP. Monthly sales call report documentation
         shall be provided to IntegraMed.

                  3.1.8 IVP shall distribute the Pharmaceutical Products to
         Customers of the Medical Practices in accordance with all applicable
         laws and regulations and as prescribed by physicians associated with
         the Medical Practices.

         3.2 FINANCIAL PLANNING AND GOALS. IVP shall prepare annual Net Sales
projections reflecting the anticipated revenues and expenses. IVP shall present
the projections to the Joint Committee for its approval at least 30 days prior
to the commencement of the Fiscal Year. If the Joint Committee does not agree on
the projections or any aspect thereof for any Fiscal Year, the projections for
the preceding Fiscal Year shall serve as the budget until such time as
projections are approved.

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<PAGE>

         3.3      FINANCIAL STATEMENTS.
                  --------------------

                  3.3.1 IVP shall prepare and, within 6 business days following
         the end of each month, present to IntegraMed a statement showing the
         Net Sales, related expenses and fees due IntegraMed for the month and
         for the Fiscal Year to date.

                  3.3.2 IVP shall prepare and, within 30 days following each
         Fiscal Year end, present to IntegraMed a statement showing the Net
         Sales, related expenses and fees earned by IntegraMed for the Fiscal
         Year then ended. At the election of IntegraMed, expressed in writing to
         IVP at least 90 days prior to the end of a Fiscal Year, the statement
         referred to in this Section 3.3.2 shall be audited by Amper, Politziner
         & Mattia or other independent certified public accountant, at
         IntegraMed's expense.

                  3.3.3 IVP's failure to present the statement to IntegraMed in
         accordance with Section 3.3.2 within 45 days following the end of the
         Fiscal Year shall be deemed a material breach subject to Section 8.1.2
         below.

                                    ARTICLE 4

                   DUTIES AND RESPONSIBILITIES OF INTEGRAMED

         4.1 OVERSIGHT. IntegraMed, while delegating to IVP the fulfillment of
Pharmaceutical Services to Customers of the Medical Practices through this
Agreement, shall nonetheless have active oversight in IVP's fulfillment of
Pharmaceutical Services to Customers of the Medical Practices through its
participation in the Joint Committee. IntegraMed hereby agrees that all
compensation, expenses, and travel costs for its officers, directors, employees,
and consultants, shall be paid by IntegraMed.

         4.2 COOPERATION WITH IVP. IntegraMed agrees that during the Term of
this Agreement, it will use its best efforts to cause its officers and employees
to execute such documents, agreements, notifications, and consents and take such
steps reasonably necessary to assist IVP in providing its Services under this
Agreement.

         4.3 SALES AND MARKETING. IntegraMed shall provide marketing services in
the form of Customer education concerning the availability of the Pharmacuetical
Products and training Medical Practice personnel on the availabilty of the
Pharmaceutical Products. IntegraMed shall prepare an annual sales and marketing
plan for generation of Net Sales detailing its anticipated activities in such
regard. IntegraMed shall present the plan to the Joint Committee for its
approval at least 45 days prior to the commencement of the Fiscal Year. If the
Joint Committee does not agree on the plan or any aspect thereof for any Fiscal
Year, the plan, or portion of the plan in disagreement, for the preceding Fiscal

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<PAGE>

Year shall serve as the plan until such time as a plan is the subject of
agreement. Monthly marketing activity documentation will be provided to IVP by
IntegraMed.

                                    ARTICLE 5

                        JOINT DUTIES AND RESPONSIBILITIES

         5.1 FORMATION AND OPERATION OF JOINT COMMITTEE. IVP and IntegraMed
shall establish a Joint Committee (the "Joint Committee"), which shall be
responsible for developing marketing policies for the overall provision of the
Services by IVP and IntegraMed hereunder. IntegraMed and IVP shall each be
entitled to elect two members to the Joint Committee, provided, however, that
each party shall be allowed only one vote on each matter submitted to the Joint
Committee for its vote. The representatives of IntegraMed and IVP on the Joint
Committee shall be either directors or executive officers of their respective
parties.

                  5.2 DUTIES AND  RESPONSIBILITIES  OF THE JOINT COMMITTEE.  The
Joint Committee shall have the following duties and responsibilities:

                  5.2.1 ANNUAL PROJECTIONS AND MARKETING PLANS. All annual
         projections prepared by IVP, and all sales, marketing, advertising, and
         promotions plans prepared by IntegraMed, shall be subject to the
         review, amendment, approval, and/or disapproval of the Joint Committee.
         Approval shall not be unreasonably withheld.

                  5.2.2  STRATEGIC  PLANNING.  The Joint Committee shall develop
         long-term strategic plans, from time to time.

                  5.2.3  RETAIL  PRICING  POLICIES.  The Joint  Committee  shall
         establish retail pricing policies.

                  5.2.4 PROVIDER  CONTRACT.  The Joint Committee shall have veto
         authority over marketing any managed care, PPO, HMO,  Medicare risk and
         other provider contracts to the Medical Providers.

                                    ARTICLE 6

                                 INTEGRAMED FEES

         IntegraMed  shall be paid a marketing  services  fee,  accrued and paid
monthly but reconciled to the annual results of operations,  equal to 50% of the
amount of Net Sales less the sum of (a) the Cost of Pharmaceutical Products, (b)
Cost of Operations for such month, (c) Direct Costs for such month and (d) the

                                  Page 7 of 21
<PAGE>

applicable IVP Sales Intervention Fees set forth on Exhibit 0.2 (the Marketing
Services Fee"). The Marketing Services Fee shall be paid to IntegraMed on or
before the 20th calendar day following the month in which the Marketing Services
Fee is earned.

                                    ARTICLE 7

                    EXCLUSIVE SERVICE RIGHT, TERM AND RENEWAL

         7.1 IntegraMed grants IVP the exclusive right to provide the
Pharmaceutical Services on behalf of IntegraMed during the Term of this
Agreement.

         7.2 The term of this Agreement shall begin on October 1, 2005 (the
"Effective Date") and shall expire on June 30, 2009 (unless this Agreement is
renewed from time to time as provided in this Section 8.2) or on any earlier
date if this Agreement is terminated pursuant to Article 8 below (the Effective
Date through the date of final expiration or termination shall be referred to as
the "Term of this Agreement"). This Agreement may be renewed by either party, if
within the period of 180 days prior to the date of expiration, one party gives
notice to the other of its intention to continue this Agreement under the same
terms and conditions as set forth herein or under such different terms and
conditions as particularly set forth in the written notice and further providing
that the other party has 30 days from the date of notice to accept, reject, or
modify the offer. If within 30 days the other party does not respond or by
written notice accepts, this Agreement shall continue for an additional 10 years
under the terms and conditions as provided in the notice. In the event the offer
is not accepted, the parties agree to negotiate, in good faith, a renewal of
this Agreement.

                                    ARTICLE 8

                          TERMINATION OF THE AGREEMENT

         8.1 TERMINATION. This Agreement may be terminated by either party to
this Agreement in the event of the following, provided, however, that no party
having the right to terminate this Agreement shall be obligated to exercise such
right:

                  8.1.1 INSOLVENCY. If a receiver, liquidator, or trustee of any
         party shall be appointed by court order, or a petition to reorganize
         shall be filed against any party under any bankruptcy, reorganization,
         or insolvency law, and shall not be dismissed within 90 days, or if any
         party shall file a voluntary petition in bankruptcy or make assignment
         for the benefit of creditors, then either of the other parties may
         terminate this Agreement upon 10 days prior written notice to the other
         parties.

                  8.1.2 MATERIAL BREACH. If any party shall materially breach
         its obligations hereunder, then either of the other parties may

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<PAGE>

         terminate this Agreement by providing 30 days prior written notice to
         the breaching party detailing the nature of the breach, provided that
         the breaching party shall not have cured the breach within such 30-day
         period, or, with respect to breaches that are not curable within such
         30-day period, shall not have commenced to cure such breach within such
         30-day period and thereafter shall not have cured the breach with the
         exercise of due diligence. It shall be a material breach for IVP to
         provide the Services in a manner inconsistent with the generally
         prevailing standard of care in the delivery of pharmacy services to
         Customers, or to provide the Services in a commercially unreasonable
         manner or in a manner that wastes or destroys the assets or reputation
         of IntegraMed. IntegraMed shall have the burden of proving that IVP has
         failed to provide the Services in a commercially reasonable manner or
         has destroyed the assets or reputation of IntegraMed in an arbitration
         proceeding or court of competent jurisdiction.

                  8.1.3 ILLEGALITY. Any party may terminate this Agreement
         immediately upon receipt of notification by any local, state, or
         federal agency or court of competent jurisdiction that the conduct
         contemplated by this Agreement is forbidden by law; except that this
         Agreement shall not terminate during such period of time as to any
         party that contests such notification in good faith and the conduct
         contemplated by this Agreement is allowed to continue during such
         contest. If any governing regulatory agency asserts that the services
         provided by any party under this Agreement are unlawful and such
         assertion is not contested by such party (or if contested, the agency's
         assertion is found to be correct by a court of competent jurisdiction
         and no appeal is taken, or if any appeals are taken and the same are
         unsuccessful), this Agreement shall thereupon terminate with the same
         force as if such termination date was the date originally specified in
         this Agreement as the date of final expiration of the terms of this
         Agreement. Notwithstanding this paragraph, the parties acknowledge that
         this Agreement serves the interests of all of the parties. For these
         reasons, the parties agree to make such amendments to this Agreement as
         are necessary to conform to the opinions, reviews, and/or orders of
         regulatory and/or administrative agencies of any jurisdiction, such as
         to preserve the legality of this Agreement, provided that such are not
         to the material financial detriment of any party.

                  8.1.4 TERMINATION UPON LOSS OF LICENSE. IntegraMed may
         terminate this Agreement upon 10 days prior written notice to IVP
         should IVP's license to practice pharmacy, in any jurisdiction where
         Pharmaceutical Services are provided to Customers of Medical Practices,
         is suspended, revoked, or not renewed. Any loss, revocation, or failure
         to renew licenses of IVP shall be deemed a material breach of this
         Agreement by the party or parties whose negligence, fault, or failure
         to provide necessary information is the primary cause of such loss,
         revocation, or non-renewal.

                  8.1.5 TERMINATION UPON UNPROFITABILITY. In the event that, at
         any time following the date nine months from the Effective Date of this
         Agreement, there are no Net Sales generated from the sale of
         Pharmaceutical Products to Customers of the Medical Practices
         determined in accordance with GAAP for any period of six consecutive
         months, then any party may terminate this Agreement upon 30 days prior
         written notice to the other parties.

                  8.1.6 Terminations pursuant to Sections 8.1.1 through 8.1.5
         shall be deemed termination for cause ("Termination for Cause"), and
         shall be made by delivering a termination notice, detailing the reasons

                                  Page 9 of 21
<PAGE>

         therefor, to the non-terminating party, and providing the opportunity
         to cure under the provisions of Section 8.1.2 above. A termination for
         any other reason shall be deemed termination without cause
         ("Termination without Cause").

                                    ARTICLE 9

                             RIGHTS UPON TERMINATION

         9.1      If this Agreement is Terminated for Cause by IntegraMed, then:

                  9.1.1 The  provisions  of  Articles 10 and 11.1 shall be of no
         force and effect.

                  9.1.2 The license granted by Article 12 shall cease, and
         IntegraMed shall cease to use any such Tradename and cease to utilize
         any written materials, for delivery to Customers of Pharmaceutical
         Products, supplied by IVP.

                  9.2 If this Agreement is Terminated for Cause by IVP, then:

                  9.2.1 The  provisions  of  Articles 10 and 11.2 shall be of no
         force and effect.

                  9.2.2 The license granted by Article 12 shall cease, and
         IntegraMed shall cease to use any such Tradename and cease to utilize
         any written materials, for delivery to Customers of Pharmaceutical
         Products, supplied by IVP.

         9.3 If this Agreement is Terminated without Cause by any party, then:

                  9.3.1 If IVP is the non-terminating party, then (a) the
         provisions of Section 11.1 shall continue to apply for the periods
         specified therein; and (b) the license granted by Article 12 shall
         cease, and IntegraMed shall cease to use any such Tradename and cease
         to utilize any written materials, for delivery to Customers of
         Pharmaceutical Products, supplied by IVP.

                  9.3.2 If IntegraMed is the non-terminating party, then (a) the
         provisions of Section 11.2 shall continue to apply for the periods
         specified therein; and (b) the license granted by Article 12 shall

                                  Page 10 of 21
<PAGE>

         cease, and IntegraMed shall cease to use any such Tradename and cease
         to utilize any written materials, for delivery to Customers of
         Pharmaceutical Products, supplied by IVP.

                  9.3.3 The terminating party shall bear any (a) accounting and
         bookkeeping; and (b) severance/vacation costs associated with any
         employees which directly result from the termination.

         9.4 In the event that this Agreement is terminated for any reason, then
(a) IVP shall continue dispensing Pharmaceutical Products to Customers of the
Medical Practices that it was servicing as of the date of notice of termination
and shall continue to pay to IntegraMed the Marketing Fee as provided for herein
for so long as IVP services such Customers, and (b) IVP and IntegraMed covenant
to utilize their best efforts, for a period 90 days prior to the termination
date and 30 days thereafter, or, if the required notice of termination be only
30 days, then for the notice period and 90 days post-termination, to fully
cooperate so as to effect a transition of such Customers to IntegraMed or its
designee (the "Transition Period"). For any services provided by IVP during a
Transition Period that extend beyond the termination date, IVP shall be paid a
reasonable fee to be agreed upon between the IVP and IntegraMed, but in no event
shall such amount be less than the Cost of Operations and Service Fee, if any,
that would have been earned by IVP during the Transition Period had the
Agreement not so terminated.

                                   ARTICLE 10

                                    INSURANCE

         10.1 IVP, at its own cost, shall secure and carry insurance, covering
itself and its employees providing services under this Agreement in the minimum
amount of $1 million per incident, $3 million in the aggregate, for professional
negligence and general liability. Such insurance shall name IntegraMed as an
additional named insured. IVP shall also carry a policy of public liability and
property damage insurance with respect to the Facilities under which the insurer
agrees to indemnify IntegraMed, subject to ordinary deductibles, against all
cost, expense, and/or liability arising out of or based upon any and all claims,
accidents, injuries, and damages customarily included within the coverage of
such policies of insurance available for IVP. The minimum limits of liability of
such insurance shall be $1 million combined single limit covering bodily injury
and property damage. IntegraMed shall be an additional named insured under the
terms of such insurance coverages. A certificate of insurance evidencing such
policies shall be presented to IntegraMed within 30 days after the execution of
this Agreement. Failure to provide such certificate(s) with such period shall
constitute a material breach by IVP hereunder subject to the procedures of
Section 8.1.2 above.

         10.2 IVP shall provide IntegraMed with written notice, at least 10 days
in advance of the effective date, of any reduction, cancellation or termination
of the insurance required to be carried by each hereunder.

                                 Page 11 of 21
<PAGE>

                                   ARTICLE 11

                      NON-SOLICITATION AND NON-COMPETITION

         11.1 During the Term of this Agreement, and for a period of two years
after the termination thereof (except as provided in Section 9 above),
IntegraMed shall, not individually or through an affiliate, (a) enter into any
agreement with another independent person or entity, other than IVP, to provide
services substantially similar to the Services required under this Agreement;
(b) market or sell any pharmaceuticals to any end-user patients, except through
IVP, during the Term of this Agreement; or (c) employ or solicit for employment
any employee of IVP, or contact any employee of IVP for the purpose of
encouraging such employee to leave the employment of IVP.

         11.2 During the Term of this Agreement, and for a period of two years
after the termination thereof (except as provided in Section 9 above), IVP shall
not, either individually or through an affiliate, (a) market or sell any
Pharmaceutical Products to any patients or Customers of the Medical Practices
except with IntegraMed's marketing participation (and subject to the terms of
this Agreement), provided, however, that this prohibition shall not apply to the
Medical Practices identified on Exhibit 11.2 attached hereto who had Customers
that had purchased Pharmaceutical Products from IVP prior to the Effective Date
of this Agreement; or (b employ or solicit for employment any Employee of
IntegraMed, or its affiliates ("IntegraMed Employees"), or contact any
IntegraMed Employees for the purpose of encouraging such employees to leave
their employment.

                                   ARTICLE 12

                      Licenses and Confidential Information

          12.1 GRANT OF LICENSE. During the Term of this Agreement, IVP hereby
grants to IntegraMed a nonexclusive, personal, nonassignable, nontransferable,
royalty-free license to use the "Cycle Kit" tradename ("Tradename") in
connection with the Marketing Services to be performed pursuant to this
Agreement. IntegraMed hereby acknowledges IVP's exclusive ownership of the
Tradename.

         12.2 TRADE SECRETS, PROPRIETARY AND CONFIDENTIAL INFORMATION.
IntegraMed hereby acknowledges that it shall have access to and become familiar
with certain management information systems, trade secrets, and proprietary and
confidential information of IVP, as described and scheduled on Exhibit 12.2
("Confidential Information"). IntegraMed hereby acknowledges IVP's exclusive
ownership of Confidential Information and agrees not to use or disclose such
Confidential Information without the prior written consent of IVP, which consent
may be withheld by IVP in its sole and absolute discretion. IntegraMed shall not

                                 Page 12 of 21
<PAGE>

photocopy or otherwise duplicate any Confidential Information of another party
without the prior express written consent of the such other party except as is
required to perform services under this Agreement. All such Confidential
Information shall remain the exclusive property of IVP and shall be returned to
the proprietor immediately upon any termination of this Agreement.

                                   ARTICLE 13

                                  MISCELLANEOUS

         13.1  FURTHER  ASSURANCES.  Each party  hereto  agrees to  perform  any
further  acts and to execute  and  deliver  any  further  documents  that may be
reasonably necessary to carry out the provisions of this Agreement.

         13.2 PRIOR AGREEMENTS; AMENDMENTS. This Agreement and the accompanying
exhibits represent the entire agreement and understanding of the parties hereto
and supersedes any other prior agreements and understandings between the Parties
as to the subject matter covered hereunder, and this Agreement may not be
amended, altered, changed or terminated orally. No amendment, alteration, change
or attempted waiver of any of the provisions hereof shall be binding without the
written consent of all parties, and such amendment, alteration, change,
termination or waiver shall in no way affect the other terms and conditions of
this Agreement, which in all other respects shall remain in full force.

         13.3 ASSIGNMENT; BINDING EFFECT. This Agreement and the rights and
obligations hereunder may not be assigned without the prior written consent of
all of the parties, and any attempted assignment without such consent shall be
void and of no force and effect. Subject to such limitations on assignment, the
provisions of this Agreement shall be binding upon and shall inure to the
benefit of the parties' respective heirs, legal representatives, successors and
permitted assigns.

         13.4 WAIVER OF BREACH. The failure to insist upon strict compliance
with any of the terms, covenants or conditions herein shall not be deemed a
waiver of such terms, covenants or conditions, nor shall any waiver or
relinquishment of any right at any one or more times be deemed a waiver or
relinquishment of such right at any other time or times.

         13.5 GOVERNING LAW. This Agreement shall be governed by and construed
in accordance with the laws of the State of New York. Any and all claims,
disputes, or controversies arising under, out of, or in connection with this
Agreement or any breach thereof, shall be determined by binding arbitration in
Washington, D.C. (hereinafter "Arbitration"). The party seeking determination
shall subject any such dispute, claim or controversy to the American Arbitration
Association, Washington, D.C., and the rules of commercial arbitration of the

                                 Page 13 of 21
<PAGE>

selected entity shall govern. The Arbitration shall be conducted and decided by
three arbitrators, unless the parties mutually agree, in writing at the time of
the Arbitration, to fewer arbitrators. In reaching a decision, the arbitrators
shall have no authority to change or modify any provision of this Agreement,
including any liquidated damages provision. Each party shall bear its own
expenses and one-half the expenses and costs of the arbitrators. Any application
to compel Arbitration, confirm, or vacate an arbitral award or otherwise enforce
this Section shall be brought only in the Courts of the States of New York or
Texas or the United States District Courts for the Southern District of New York
or the Northern District of Texas, to whose jurisdiction for such purposes
IntegraMed and IVP hereby irrevocably consent and submit.

         13.6 SEPARABILITY. If any portion of the provisions hereof shall to any
extent be invalid or unenforceable, the remainder of this Agreement, or the
application of such portion or provisions in circumstances other than those in
which it is held invalid or unenforceable, shall not be affected thereby, and
each portion or provision of this Agreement shall be valid and enforced to the
fullest extent permitted by law, but only to the extent the same continues to
reflect fairly the intent and understanding of the parties expressed by this
Agreement take as a whole.

         13.7 HEADINGS. Section and paragraph headings are not part of this
Agreement and are included solely for convenience and are not intended to be
full or accurate descriptions of the contents thereof.

         13.8 NOTICES. Any notice hereunder shall have been deemed to have been
given only if in writing and either delivered in hand or sent by registered or
certified mail, return receipt requested, postage prepaid, or by United States
Express Mail or other commercial expedited delivery service, with all postage
and delivery charges prepaid, to the addresses set forth below:

                  13.8.1            If for IntegraMed:

                                    Jay Higham, President
                                    IntegraMed America, Inc.
                                    Two Manhattanville Road
                                    Purchase, NY 10577-2100

                  13.8.2            If for IVP:

                                    Von L. Best, President & CEO
                                    ivpcare, inc.
                                    7164 Technology Drive
                                    Suite 100
                                    Frisco, TX 75034

                                 Page 14 of 21
<PAGE>

         Either party hereto, by like notice to the other parties, may designate
such other address or addresses to which notice must be sent.

         13.9     INDEMNIFICATION.

                  13.9.1 IVP agrees to indemnify and hold harmless IntegraMed,
         its shareholders, directors, officers, employees and servants from any
         suits, claims, actions, losses, liabilities or expenses (including
         reasonable attorney's fees and costs) arising out of or in connection
         with any act or failure to act by IVP related to the performance of its
         duties and responsibilities under this Agreement. The obligations
         contained in this Section 13.9.1 shall survive termination of this
         Agreement.

                  13.9.2 IntegraMed agree to indemnify and hold harmless IVP,
         its shareholders, directors, officers, employees and servants from any
         suits, claims, actions, losses, liabilities or expenses (including
         reasonable attorney's fees and costs) arising out of or in connection
         with any act or failure to act by IntegraMed related to the performance
         of its duties and responsibilities under this Agreement. The
         obligations contained in this Section 13.9.2 shall survive termination
         of this Agreement.

                  13.9.3 In the event of any claims or suits in which IVP and/or
         IntegraMed, their directors, officers, employees and servants are
         named, each of IVP and IntegraMed, for their respective directors,
         officers, employees agree to cooperate in the defense of such suit or
         claim; such cooperation shall include, by way of example but not
         limitation, meeting with defense counsel (to be selected by the
         respective party hereto), the production of any documents in his/her
         possession for review, response to subpoenas and the coordination of
         any individual defense with counsel for the respective parties hereto.
         The respective party shall, as soon as practicable, deliver to the
         other copies of any summonses, complaints, suit letters, subpoenas or
         legal papers of any kind, served upon such party, for which such party
         seeks indemnification hereunder. This obligation to cooperate in the
         defense of any such claims or suits shall survive the termination, for
         whatever reason. of this Agreement.

                  13.9.4 Promptly after the receipt by IntegraMed of notice of
         any claim or commencement of any action or proceeding subject to
         indemnification delineated in Section 13.9.1 ("asserted liability"),
         IntegraMed, will demand such indemnification from IVP and proffer the
         defense to IVP. IVP may thereafter, at its option, assume such defense
         at its own expense and by its own counsel. IVP shall provide written
         notice to IntegraMed, within 20 days, of its assumption or declination
         of such defense. If IVP shall undertake to compromise any asserted
         liability, it shall promptly notify IntegraMed, of its intention to do
         so and IntegraMed, agrees to cooperate fully and promptly with IVP and
         its counsel in the compromise and defense of any asserted liability.

                                 Page 15 of 21
<PAGE>

         IVP shall not enter into any non-monetary settlement hereunder without
         the prior written consent of IntegraMed. Notwithstanding the foregoing,
         IntegraMed shall have the right to participate in the compromise or
         defense of any asserted liability with its own counsel and at its own
         expense.

                  13.9.5 Promptly after the receipt by IVP of notice of any
         claim or commencement of any action or proceeding subject to
         indemnification delineated in Section 13.9.2 ("asserted liability"),
         IVP will demand such indemnification from IntegraMed, and proffer the
         defense to such party. Such party may thereafter, at its option, assume
         such defense at its own expense and by its own counsel. Such party
         shall provide written notice to IVP, within 20 days, of its assumption
         or declination of such defense. If IntegraMed, shall undertake to
         compromise any asserted liability, it shall promptly notify the IVP of
         its intention to do so and IVP agrees to cooperate fully and promptly
         with IVP and its counsel in the compromise and defense of any asserted
         liability. IntegraMed not shall enter into any non-monetary settlement
         hereunder without the prior written consent of IVP. Notwithstanding the
         foregoing, IVP shall have the right to participate in the compromise or
         defense of any asserted liability with its own counsel and at its own
         expense.

         13.10 CONSTRUCTION. Each party and its counsel have participated fully
in the review and revision of this Agreement. In construing this Agreement, it
shall be deemed to have been drafted jointly.

         IN WITNESS WHEREOF, this Agreement has been executed by the parties
hereto as of the day and year first above written.

IVPCARE, INC.

By: /s/  Von L. Best
   -------------------------------
         Von L. Best, President

INTEGRAMED AMERICA, INC.

By:  /s/  Jay Higham
   ------------------------------
         Jay Higham, President

                                 Page 16 of 21
<PAGE>

                                   EXHIBIT 0.2

                               Medical Practices

A.  1% Sales  Support  Fee- IVP will  deduct a Sales  Support  Fee of 1% of Net
Sales for the following Medical Practices:

    1. Reproductive Science Center of Boston
    2. Reproductive Endocrinology Associates of Charlotte
    3. Reproductive Science Center of the Bay Area Fertility and Gynecology
       Medical Group
    4. Fertility Centers of Illinois
    5. Shady Grove Fertility Centers
    6. IVF Florida Reproductive Associates
    7. Seattle Reproductive Medicine
    8. Reproductive Partners Medical Group

B.  3% Sales  Support  Fee- IVP will  deduct a Sales  Support  Fee of 3% of Net
Sales for the following Medical Practices:

    1. Reproductive Medicine Associates of New Jersey- Morristown, NJ
    2. Reproductive Science Associates- Mineola, New York and Stony Brook, NY
    3. Atlanta Center for Reproductive Medicine- Atlanta, GA
    4. Southeastern Fertility Center- Mt.Pleasant, SC
    5. Midwest Reproductive Medicine- Indianapolis, IN
    6. Center for Assisted Reproduction- Bedford, TX
    7. Center for Reproductive Medicine- Minneapolis, MN
    8. Colorado Center for Reproductive Medicine- Englewood, CO
    9. The Center for Reproductive Medicine- Mobile, AL
   10. Reproductive Resource Center- Overland, Kansas
   11. Abington Reproductive Medicine-Philadelphia, PA
   12. Oregon Health & Science University Consultants/Oregon Health & Science
       University Medical Group

                                 Page 17 of 21
<PAGE>

                                  EXHIBIT 1.1.1

                       Cost of Operations (% of Net Sales)

            ----------------------------------------------------------
                         Monthly                   Cost Of
                     Net Sales Operations
            ----------------------------------------------------------
            ----------------------------------------------------------
                     $25,000 or more               22.84%
                     $50,000 or more               17.15%
                     $100,000 or more              14.30%
                     $200,000 or more              12.86%
                     $400,000 or more              12.16%
                     $800,000 or more              11.81%
                     $1,250,000 or more            11.68%
                     $1,500,00 or more             11.64%

                                 Page 18 of 21
<PAGE>

                                  EXHIBIT 1.1.2

                         Cost of Pharmaceutical Products

         IVP will purchase Pharmaceutical Products using its wholesale license.
IVP will apply its utilization and market-share rebates related to the provision
of the Services; however, IVP will not apply its trade discounts received as
incentive for timely payment, or its discounts on bulk purchases as defined
below. These guidelines yield the following rebate structure as of the Effective
Date of this Agreement:

Qualifying Rebates (Passed along with respect to the provision of the Services):
-------------------------------------------------------------------------------
1.   The variable Serono market-share rebates and the Serono Volume Rebates.
2.   The Organon utilization rebates.
3.   The Ferring market-share rebates.

Non-Qualifying Rebates (Kept by IVP):
-------------------------------------
1.   All rebates given as incentive for timely payment (e.g., 2% 30/ Net 31).

Other Issues:

1.   A few manufacturers,  e.g., TAP, do not offer any rebates,  and IVP buys at
     Wholesale  Acquisition  Cost (WAC).  These  products  will be billed at net
     invoice +2%.

2.   From time to time, IVP may receive additional  discounts from manufacturers
     for committing to bulk purchases. The quantities usually represent a three-
     to 12-month  supply,  and the value of the discounts is partially offset by
     IVP's cost of capital,  storage costs, and property taxes.  These discounts
     will not be applied with respect to provision of the Services

3.   WAC will be the basis by which all  products  costs  will be  applied  with
     respect to provision of the Services.  Qualifying rebates that are taken by
     IVP at time of payment  will be passed  with  respect to  provision  of the
     Services on IVP's invoice.  Qualifying  rebates that are received via check
     from the  manufacture  at a later time will be estimated and accrued in the
     monthly financials with respect to Net Sales.

                                 Page 19 of 21
<PAGE>

                                  EXHIBIT 11.2

                IVP's Prior Relationships with Medical Practices

1.  Reproductive Science Center of Boston
2.  Shady Grove Reproductive Science Centers, Inc.

                                 Page 20 of 21

<PAGE>

                                  EXHIBIT 13.2

         IVP's Trade Secrets, Proprietary, and Confidential Information

1.  All information related to IVP that is not directly related to IntegraMed
2.  IVP retail pricing structure.
3.  All internal policies and procedures used by IVP.
4.  IVP's rebate  structure  with all  pharmaceutical  drug  manufacturers  and
    distributors.
5.  IVP's business plans and strategies.
6.  IVP's customer relationships, referral sources, payors, and patients.
7.  IVP's dispensing and drug utilization data.
8.  IVP's  trade  names  and  programs  developed  for  its   direct-to-patient
    distribution services.
9.  Any other material, programs, or systems that IVP deems as confidential.

                                 Page 21 of 21exv10w36

 

Exhibit 10.36

THE GREENBRIER COMPANIES

Amendment No. 1

to

2005 Stock Incentive Plan

     Pursuant to Section 15.2 of the 2005 Stock Incentive Plan (the “Plan”) of The Greenbrier
Companies (the “Company”), the Board of Directors of the Company has amended the Plan as follows:

	 	1.	 	Director Restricted Shares. Section 6.1 of the Plan is amended to
increase the amount of the annual automatic award of restricted stock to non-employee
directors from $42,500 in value of stock to $60,000 per year, effective as of January
2006.
	 
	 	2.	 	Payment of Par Value for Shares. The Plan is amended to delete the
requirement that the par value for shares purchased under the Plan be paid in cash.
Specifically, Section 7.5 is amended to delete the second sentence of that Section, and
the second sentence of Section 9.2 is amended by deleting the phrase “..., for the
amount in excess of the par value of such newly issued Restricted Shares,...”.
	 
	 	3.	 	Effective Date. Except as otherwise provided herein, this Amendment
No. 1 shall be effective as of the date of approval by the Board of Directors. Except
as hereby amended, the Plan shall remain in full force and effect.

Approved by the Board of Directors June 30, 2005

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