Document:

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                                                                     Exhibit 4.2

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                              TRIAD HOSPITALS, INC.

                            (a Delaware corporation)

                     7.0% Senior Subordinated Notes due 2013

                               PURCHASE AGREEMENT

Dated: November 6, 2003

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                                TABLE OF CONTENTS

SECTION 1.    REPRESENTATIONS AND WARRANTIES BY THE COMPANY

     (a)   Representations and Warranties......................................3
           (i)      Offering Memorandum........................................3
           (ii)     Incorporated Documents.....................................3
           (iii)    Independent Accountants....................................3
           (iv)     Financial Statements.......................................3
           (v)      No Material Adverse Change in Business.....................4
           (vi)     Good Standing of the Company...............................4
           (vii)    Good Standing of Designated Subsidiaries...................4
           (viii)   Capitalization.............................................5
           (ix)     Authorization of Agreement.................................5
           (x)      Authorization of the Indenture.............................5
           (xi)     Authorization of the Original Securities...................5
           (xii)    Authorization of the Registration Rights Agreement.........5
           (xiii)   Authorization of the Exchange Securities...................6
           (xiv)    Description of the Securities and the Indenture............6
           (xv)     Absence of Defaults and Conflicts..........................6
           (xvi)    Absence of Labor Dispute...................................7
           (xvii)   Absence of Proceedings.....................................7
           (xviii)  Absence of Further Requirements............................7
           (xix)    Possession of Licenses and Permits.........................8
           (xx)     Title to Property..........................................8
           (xxi)    Environmental Laws.........................................8
           (xxii)   Investment Company Act.....................................9
           (xxiii)  Similar Offerings..........................................9
           (xxiv)   Rule 144A Eligibility......................................9
           (xxv)    No General Solicitation....................................9
           (xxvi)   No Registration Required..................................10
           (xxvii)  Reporting Company.........................................10
           (xxviii) Regulations T, U and X....................................10
           (xxix)   Medicare and Medicaid.....................................10
           (xxx)    Internal Accounting Controls..............................11
           (xxxi)   Insurance.................................................11
     (b)   Officer's Certificates.............................................11

SECTION 2.    SALE AND DELIVERY TO INITIAL PURCHASERS; CLOSING

     (a)   Securities.........................................................11
     (b)   Payment............................................................11
     (c)   Denominations; Registration........................................12

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SECTION 3.    COVENANTS OF THE COMPANY

     (a)   Offering Memorandum................................................12
     (b)   Notice and Effect of Material Events...............................12
     (c)   Amendment to Offering Memorandum and Supplements...................12
     (d)   Qualification of Securities for Offer and Sale.....................13
     (e)   Rating of Securities...............................................13
     (f)   DTC................................................................13
     (g)   Use of Proceeds....................................................13
     (h)   Restriction on Sale of Securities..................................13
     (i)   PORTAL Designation.................................................13
     (j)   Reporting Requirements.............................................13

SECTION 4.    PAYMENT OF EXPENSES

     (a)   Expenses...........................................................13
     (b)   Termination of Agreement...........................................14

SECTION 5.    CONDITIONS OF INITIAL PURCHASERS' OBLIGATIONS

     (a)   Opinion of Counsel for Company.....................................14
     (b)   Opinion of Counsel for Initial Purchasers..........................14
     (c)   Officers' Certificate..............................................15
     (d)   Accountants' Comfort Letter........................................15
     (e)   Bring-down Comfort Letter..........................................15
     (f)   Rating.............................................................15
     (g)   PORTAL.............................................................15
     (h)   Additional Documents...............................................16
     (i)   Termination of Agreement...........................................16

SECTION 6.    SUBSEQUENT OFFERS AND RESALES OF THE SECURITIES

     (a)   Offer and Sale Procedures..........................................16
           (i)      Offers and Sales only to Qualified Institutional
                       Buyers.................................................16
           (ii)     No General Solicitation...................................16
           (iii)    Purchases by Non-Bank Fiduciaries.........................16
           (iv)     Subsequent Purchaser Notification.........................16
           (v)      Minimum Principal Amount..................................17
           (vi)     Restrictions on Transfer..................................17
           (vii)    Delivery of Offering Memorandum...........................17
     (b)   Covenants of the Company...........................................17
           (i)      Integration...............................................17
           (ii)     Rule 144A Information.....................................17
           (iii)    Restriction on Repurchases................................18

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     (c)   Qualified Institutional Buyer......................................18
     (d)   Resale Pursuant to Rule 144A.......................................18
     (e)   Additional Representations and Warranties of Initial Purchasers....18

SECTION 7.    INDEMNIFICATION

     (a)   Indemnification of Initial Purchasers..............................18
     (b)   Indemnification of Company.........................................19
     (c)   Actions against Parties; Notification..............................19
     (d)   Settlement without Consent if Failure to Reimburse.................20

SECTION 8.    CONTRIBUTION

SECTION 9.    REPRESENTATIONS, WARRANTIES AND AGREEMENTS TO
              SURVIVE DELIVERY

SECTION 10.   TERMINATION OF AGREEMENT

     (a)   Termination; General...............................................22
     (b)   Termination; Tender Offer..........................................22
     (c)   Liabilities........................................................22

SECTION 11.   DEFAULT BY ONE OR MORE OF THE INITIAL PURCHASERS

SECTION 12.   NOTICES

SECTION 13.   PARTIES

SECTION 14.   TAX TREATMENT

SECTION 15.   GOVERNING LAW AND TIME

SECTION 16.   EFFECT OF HEADINGS

SECTION 17.   COUNTERPARTS

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SCHEDULES

     Schedule A - List of Initial Purchasers                             Sch A-1
     Schedule B - Pricing Information                                    Sch B-1
     Schedule C - List of Subsidiaries                                   Sch C-1

EXHIBITS

     Exhibit A-1 - Form of Opinion of Company's Counsel                  A-1-1
     Exhibit A-2 - Form of Opinion of General Counsel                    A-2-1

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                              TRIAD HOSPITALS, INC.
                            (a Delaware corporation)

                                  $600,000,000
                     7.0% Senior Subordinated Notes due 2013

                               PURCHASE AGREEMENT

                                                                November 6, 2003

MERRILL LYNCH & CO.
Merrill Lynch, Pierce, Fenner & Smith
     Incorporated
Banc of America Securities LLC
   as Representatives of the several Initial Purchasers
c/o Merrill Lynch & Co.
Merrill Lynch, Pierce, Fenner & Smith
     Incorporated
4 World Financial Center, North Tower
New York, New York 10080

Ladies and Gentlemen:

          Triad Hospitals, Inc., a Delaware corporation (the "Company"),
confirms its agreement with Merrill Lynch & Co., Merrill Lynch, Pierce, Fenner &
Smith Incorporated ("Merrill Lynch"), Banc of America Securities LLC ("Banc of
America") and each of the other Initial Purchasers named in Schedule A hereto
(collectively, the "Initial Purchasers", which term shall also include any
initial purchaser substituted as hereinafter provided in Section 11 hereof), for
whom Merrill Lynch and Banc of America are acting as representatives (in such
capacity, the "Representatives"), with respect to the issue and sale by the
Company and the purchase by the Initial Purchasers, acting severally and not
jointly, of the respective principal amounts set forth in said Schedule A of
$600,000,000 aggregate principal amount of the Company's 7.0% Senior
Subordinated Notes due 2013 (the "Original Securities"). The Original Securities
are to be issued pursuant to an indenture dated as of November 12, 2003 (the
"Indenture") between the Company and Citibank, N.A., as trustee (the "Trustee").
Original Securities issued in book-entry form will be issued to Cede & Co. as
nominee of The Depository Trust Company ("DTC") pursuant to a letter agreement,
to be dated as of the Closing Time (as defined in Section 2(b)) (the "DTC
Agreement"), among the Company, the Trustee and DTC.

          The Company understands that the Initial Purchasers propose to make an
offering of the Original Securities on the terms and in the manner set forth
herein and agrees that the Initial Purchasers may resell, subject to the
conditions set forth herein, all or a portion of the Original Securities to
purchasers ("Subsequent Purchasers") at any time after this Agreement has been
executed and delivered. The Original Securities are to be offered and sold
through the Initial Purchasers without being registered under the Securities Act
of 1933, as amended (the "1933 Act"), in reliance upon exemptions therefrom.
Pursuant to the terms of the Original Securities and the Indenture, investors
that acquire Original Securities may only resell or otherwise transfer

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such Original Securities if such Original Securities are hereafter registered
under the 1933 Act or if an exemption from the registration requirements of the
1933 Act is available (including the exemption afforded by Rule 144A ("Rule
144A") of the rules and regulations promulgated under the 1933 Act by the
Securities and Exchange Commission (the "Commission")).

          The Company has prepared and delivered to each Initial Purchaser
copies of a preliminary offering memorandum dated November 3, 2003 (the
"Preliminary Offering Memorandum") and has prepared and will deliver to each
Initial Purchaser, on the date hereof or the next succeeding day, copies of a
final offering memorandum dated November 6, 2003 (the "Final Offering
Memorandum"), each for use by such Initial Purchaser in connection with its
solicitation of purchases of, or offering of, the Original Securities. "Offering
Memorandum" means, with respect to any date or time referred to in this
Agreement, the most recent offering memorandum (whether the Preliminary Offering
Memorandum or the Final Offering Memorandum, or any amendment or supplement to
either such document), including exhibits thereto and any documents incorporated
therein by reference, which has been prepared and delivered by the Company to
the Initial Purchasers in connection with their solicitation of purchases of, or
offering of, the Original Securities.

          Holders (including subsequent transferees) of the Original Securities
will have the registration rights set forth in the registration rights agreement
(the "Registration Rights Agreement") to be dated the Closing Time in form and
substance reasonably satisfactory to the Initial Purchasers and conforming to
the description thereof in the Offering Memorandum, for so long as such Original
Securities constitute "Registrable Securities" (as defined in the Registration
Rights Agreement). Pursuant to the Registration Rights Agreement, the Company
will agree to (i) file with the Commission under the circumstances set forth in
the Registration Rights Agreement, (a) a registration statement under the 1933
Act (the "Exchange Offer Registration Statement") relating to the issue of debt
securities (collectively with the Private Exchange Securities (as defined in the
Registration Rights Agreement), the "Exchange Securities" and, together with the
Original Securities, the "Securities,") to be offered in exchange for the
Original Securities (the "Exchange Offer") and issued under the Indenture or an
indenture substantially identical to the Indenture and/or (b) under certain
circumstances set forth in the Registration Rights Agreement, a shelf
registration statement pursuant to Rule 415 under the Securities Act (the "Shelf
Registration Statement" and together with the Exchange Offer Registration
Statement, the "Registration Statements") relating to the resale by certain
holders of the Original Securities and (ii) use their reasonable best efforts to
cause such Registration Statements to be declared effective. This Agreement, the
Original Securities, the Indenture and the Registration Rights Agreement are
hereinafter sometimes referred to collectively as the "Transaction Documents."

          All references in this Agreement to financial statements and schedules
and other information which is "contained," "included" or "stated" in the
Offering Memorandum (or other references of like import) shall be deemed to mean
and include all such financial statements and schedules and other information
which are incorporated by reference in the Offering Memorandum; and all
references in this Agreement to amendments or supplements to the Offering
Memorandum shall be deemed to mean and include the filing of any document under
the Securities Exchange Act of 1934 (the "1934 Act") which is incorporated by
reference in the Offering Memorandum.

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          SECTION 1. Representations and Warranties by the Company.

          (a) Representations and Warranties. The Company represents and
warrants to each Initial Purchaser as of the date hereof and as of the Closing
Time referred to in Section 2(b) hereof, and agrees with each Initial Purchaser,
as follows:

               (i) Offering Memorandum. The Offering Memorandum does not, and at
          the Closing Time will not, include an untrue statement of a material
          fact or omit to state a material fact necessary in order to make the
          statements therein, in the light of the circumstances under which they
          were made, not misleading; provided that this representation, warranty
          and agreement shall not apply to statements in or omissions from the
          Offering Memorandum made in reliance upon and in conformity with
          information furnished to the Company in writing by any Initial
          Purchaser through the Representatives expressly for use in the
          Offering Memorandum.

               (ii) Incorporated Documents. The Offering Memorandum as delivered
          from time to time shall incorporate by reference the most recent
          Annual Report of the Company on Form 10-K filed with the Commission
          and each Quarterly Report of the Company on Form 10-Q and each Current
          Report of the Company on Form 8-K filed with the Commission (other
          than those furnished to the Commission) since the filing of the end of
          the fiscal year to which such Annual Report relates. The documents
          incorporated by reference in the Offering Memorandum at the time they
          were or hereafter are filed with the Commission complied or will
          comply in all material respects with the requirements of the 1934 Act
          and the rules and regulations of the Commission thereunder (the "1934
          Act Regulations").

               (iii) Independent Accountants. The accountants who certified the
          financial statements and supporting schedules included in the Offering
          Memorandum are independent public accountants with respect to the
          Company and its subsidiaries within the meaning of Regulation S-X
          under the 1933 Act.

               (iv) Financial Statements. The financial statements, together
          with the related schedules and notes, included in the Offering
          Memorandum present fairly in all material respects the financial
          position of the Company and its consolidated subsidiaries at the dates
          indicated and the statement of operations, stockholders' equity and
          cash flows of the Company and its consolidated subsidiaries for the
          periods specified; said financial statements have been prepared in
          conformity with generally accepted accounting principles ("GAAP")
          applied on a consistent basis throughout the periods involved. The
          selected financial data and the summary financial information included
          in the Offering Memorandum present fairly the information shown
          therein and have been compiled on a basis consistent with that of the
          audited financial statements included in the Offering Memorandum.

                                      -3-

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               (v) No Material Adverse Change in Business. Since the respective
          dates as of which information is given in the Offering Memorandum,
          except as otherwise stated therein, (A) there has been no material
          adverse change in the condition, financial or otherwise, or in the
          earnings or business affairs of the Company and its subsidiaries
          considered as one enterprise, whether or not arising in the ordinary
          course of business (a "Material Adverse Effect"), (B) there have been
          no transactions entered into by the Company or any of its
          subsidiaries, other than those in the ordinary course of business,
          which are material with respect to the Company and its subsidiaries
          considered as one enterprise, and (C) there has been no dividend or
          distribution of any kind declared, paid or made by the Company on any
          class of its capital stock.

               (vi) Good Standing of the Company. The Company has been duly
          organized and is validly existing as a corporation in good standing
          under the laws of the State of Delaware and has corporate power and
          authority to own, lease and operate its properties and to conduct its
          business as described in the Offering Memorandum and to enter into and
          perform its obligations under this Agreement; and the Company is duly
          qualified as a foreign corporation to transact business and is in good
          standing in each other jurisdiction in which such qualification is
          required, whether by reason of the ownership or leasing of property or
          the conduct of business, except where the failure so to qualify or to
          be in good standing would not result in a Material Adverse Effect.

               (vii) Good Standing of Designated Subsidiaries. Each "significant
          subsidiary" of the Company (as such term is defined in Rule 1-02 of
          Regulation S-X) (each a "Designated Subsidiary" and, collectively, the
          "Designated Subsidiaries") has been duly organized and is validly
          existing as a corporation, a limited liability company or a limited
          partnership in good standing under the laws of the jurisdiction of its
          incorporation or formation has the requisite power and authority to
          own, lease and operate its properties and to conduct its business as
          described in the Offering Memorandum and is duly qualified as a
          foreign corporation, limited liability company or limited partnership
          to transact business and is in good standing in each jurisdiction in
          which such qualification is required, whether by reason of the
          ownership or leasing of property or the conduct of business, except
          where the failure so to qualify or to be in good standing would not
          result in a Material Adverse Effect; except as otherwise disclosed in
          the Offering Memorandum, all of the issued and outstanding capital
          stock or ownership interests of each Designated Subsidiary has been
          duly authorized and validly issued, is fully paid and non-assessable
          and is owned by the Company, directly or through subsidiaries, free
          and clear of any security interest, mortgage, pledge, lien,
          encumbrance, claim or equity other than those under the Company's
          Senior Secured Credit Agreement (as defined in the Offering
          Memorandum); none of the outstanding shares of capital stock or
          ownership interests of the Designated Subsidiaries was issued in
          violation of any preemptive or similar rights of any securityholder of
          such Designated Subsidiary.

                                      -4-

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               (viii) Capitalization. The authorized, issued and outstanding
          capital stock of the Company is as set forth in the Offering
          Memorandum under the caption "Capitalization" (except for subsequent
          issuances, if any, pursuant to this Agreement, pursuant to
          reservations, agreements, employee benefit plans referred to in the
          Offering Memorandum or pursuant to the exercise of convertible
          securities or options referred to in the Offering Memorandum). The
          shares of issued and outstanding capital stock of the Company have
          been duly authorized and validly issued and are fully paid and
          non-assessable; none of the outstanding shares of capital stock of the
          Company was issued in violation of the preemptive or other similar
          rights of any securityholder of the Company.

               (ix) Authorization of Agreement. This Agreement has been duly
          authorized, executed and delivered by the Company.

               (x) Authorization of the Indenture. The Indenture has been duly
          authorized by the Company and, when executed and delivered by the
          Company and the Trustee, will constitute a valid and binding agreement
          of the Company, enforceable against the Company in accordance with its
          terms, except as the enforcement thereof may be limited by bankruptcy,
          insolvency (including, without limitation, all laws relating to
          fraudulent transfers), reorganization, moratorium or similar laws
          affecting enforcement of creditors' rights generally and except as
          enforcement thereof is subject to public policy considerations and
          general principles of equity (regardless of whether enforcement is
          considered in a proceeding in equity or at law).

               (xi) Authorization of the Original Securities. The Original
          Securities have been duly authorized and, at the Closing Time, will
          have been duly executed by the Company and, when authenticated, issued
          and delivered in the manner provided for in the Indenture and
          delivered against payment of the purchase price therefor as provided
          in this Agreement, will constitute valid and binding obligations of
          the Company, enforceable against the Company in accordance with their
          terms, except as the enforcement thereof may be limited by bankruptcy,
          insolvency (including, without limitation, all laws relating to
          fraudulent transfers) reorganization, moratorium or similar laws
          affecting enforcement of creditors' rights generally and except as
          enforcement thereof is subject to public policy considerations and
          general principles of equity (regardless of whether enforcement is
          considered in a proceeding in equity or at law), and will be in the
          form contemplated by, and entitled to the benefits of, the Indenture.

               (xii) Authorization of the Registration Rights Agreement. The
          Registration Rights Agreement has been duly authorized by the Company
          and, at the Closing Time, will have been duly executed and delivered
          by the Company and will constitute a valid and binding agreement of
          the Company, enforceable against the Company in accordance with its
          terms, except as (A) the enforcement thereof may be limited by
          bankruptcy, insolvency (including, without limitation, all laws
          relating to fraudulent transfers), reorganization, moratorium or
          similar laws affecting enforcement of creditors' rights generally and
          except as enforcement

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          thereof is subject to public policy considerations and general
          principles of equity (regardless of whether enforcement is considered
          in a proceeding in equity or at law) and (B) any rights to indemnity
          or contribution thereunder may be limited by federal and state
          securities laws and public policy considerations. On the Closing Date,
          the Registration Rights Agreement will conform in all material
          respects to the description thereof in the Offering Memorandum under
          the caption "Exchange Offer; Registration Rights."

               (xiii) Authorization of the Exchange Securities. The Exchange
          Securities have been, or on the Closing Time will be, duly and validly
          authorized for issuance by the Company and, when issued and
          authenticated by the Trustee and delivered to the Company in
          accordance with the terms of the Registration Rights Agreement, the
          Exchange Offer and the Indenture (assuming due authorization,
          execution and delivery thereof by the Trustee), the Exchange
          Securities will be legal, valid and binding obligations of the
          Company, entitled to the benefits of the Indenture and enforceable
          against the Company in accordance with their terms, except as the
          enforcement thereof may be limited by bankruptcy, insolvency
          (including, without limitation, all laws relating to fraudulent
          transfers) reorganization, moratorium or similar laws affecting
          enforcement of creditors' rights generally and except as enforcement
          thereof is subject to public policy considerations and general
          principles of equity (regardless of whether enforcement is considered
          in a proceeding in equity or at law), and will be in the form
          contemplated by, and entitled to the benefits of the Indenture.

               (xiv) Description of the Securities and the Indenture. The
          Securities and the Indenture will conform in all material respects to
          the respective statements relating thereto contained in the Offering
          Memorandum and will be in substantially the respective forms last
          delivered to the Initial Purchasers prior to the date of this
          Agreement.

               (xv) Absence of Defaults and Conflicts. Neither the Company nor
          any of its subsidiaries is in violation of its charter or by-laws or
          in default in the performance or observance of any obligation,
          agreement, covenant or condition contained in any contract, indenture,
          mortgage, deed of trust, loan or credit agreement, note, lease or
          other agreement or instrument to which the Company or any of its
          subsidiaries is a party or by which or any of them may be bound, or to
          which any of the property or assets of the Company or any of its
          subsidiaries is subject (collectively, "Agreements and Instruments")
          except for such defaults that would not result in a Material Adverse
          Effect; and the execution, delivery and performance of this Agreement,
          the Indenture, the Registration Rights Agreement and the Securities
          and any other agreement or instrument entered into or issued or to be
          entered into or issued by the Company in connection with the
          transactions contemplated hereby or thereby or in the Offering
          Memorandum and the consummation of the transactions contemplated
          herein and in the Offering Memorandum (including the issuance and sale
          of the Securities and the use of the proceeds from the sale of the
          Securities as described in the Offering Memorandum under the caption
          "Use of Proceeds") and compliance by the Company with its obliga-

                                      -6-

<PAGE>

          tions hereunder have been duly authorized by all necessary corporate
          action and do not and will not, whether with or without the giving of
          notice or passage of time or both, conflict with or constitute a
          breach of, or default or a Repayment Event (as defined below) under,
          or result in the creation or imposition of any lien, charge or
          encumbrance upon any property or assets of the Company or any of its
          subsidiaries pursuant to, the Agreements and Instruments except for
          such conflicts, breaches, defaults, Repayment Events, liens, charges
          or encumbrances that, singly or in the aggregate, would not result in
          a Material Adverse Effect, nor will such action result in any
          violation of the provisions of the charter or by-laws of the Company
          or any of its subsidiaries or, except as would not have a Material
          Adverse Effect, any applicable law, statute, rule, regulation,
          judgment, order, writ or decree of any government, government
          instrumentality or court, domestic or foreign, having jurisdiction
          over the Company or any of its subsidiaries or any of their assets,
          properties or operations. As used herein, a "Repayment Event" means
          any event or condition which gives the holder of any note, debenture
          or other evidence of indebtedness (or any person acting on such
          holder's behalf) the right to require the repurchase, redemption or
          repayment of all or a portion of such indebtedness by the Company or
          any of its subsidiaries.

               (xvi) Absence of Labor Dispute. No labor dispute with the
          employees of the Company or any of its subsidiaries exists or, to the
          knowledge of the Company, is imminent which, in either case, would
          reasonably be expected to result in a Material Adverse Effect.

               (xvii) Absence of Proceedings. Except as disclosed in the
          Offering Memorandum, there is no action, suit, proceeding, inquiry or
          investigation before or brought by any court or governmental agency or
          body, domestic or foreign, now pending, or, to the knowledge of the
          Company, threatened, against or affecting the Company or any of its
          subsidiaries which would reasonably be expected to result in a
          Material Adverse Effect, or which would reasonably be expected to
          materially and adversely affect the consummation of the transactions
          contemplated by this Agreement or the performance by the Company of
          its obligations hereunder. The aggregate of all pending legal or
          governmental proceedings to which the Company or any of its
          subsidiaries is a party or of which any of their respective property
          or assets is the subject which are not described in the Offering
          Memorandum, including ordinary routine litigation incidental to the
          business, would not reasonably be expected to result in a Material
          Adverse Effect.

               (xviii) Absence of Further Requirements. No filing with, or
          authorization, approval, consent, license, order, registration,
          qualification or decree of, any court or governmental authority or
          agency is necessary or required for the performance by the Company of
          its obligations hereunder, in connection with the offering, issuance
          or sale of the Securities hereunder or the consummation of the
          transactions contemplated by this Agreement or for the due execution,
          delivery or performance of the Indenture by the Company, except (A)
          such as have been already obtained, (B) in connection with the
          registration of the Exchange Securities pursuant to the Registration
          Rights Agreement, (C) any filings under state securi-

                                      -7-

<PAGE>

          ties or Blue Sky laws in connection with the sale of the Securities,
          (D) the qualification of the Indenture under the Trust Indenture Act
          in connection with the Exchange Offer and (E) such filing,
          authorization, approval, consent, license, order, registration,
          qualification or decree the failure to so make or obtain would not
          have a Material Adverse Effect.

               (xix) Possession of Licenses and Permits. The Company and its
          subsidiaries possess such permits, licenses, approvals, consents and
          other authorizations (collectively, "Governmental Licenses") issued by
          the appropriate federal, state, local or foreign regulatory agencies
          or bodies necessary to conduct the business now operated by them
          except as disclosed in the Offering Memorandum or where the failure to
          so possess would not have a Material Adverse Effect; the Company and
          its subsidiaries are in compliance with the terms and conditions of
          all such Governmental Licenses, except where the failure so to comply
          would not, singly or in the aggregate, have a Material Adverse Effect;
          all of the Governmental Licenses are valid and in full force and
          effect, except as disclosed in the Offering Memorandum or where the
          invalidity of such Governmental Licenses or the failure of such
          Governmental Licenses to be in full force and effect would not have a
          Material Adverse Effect; and neither the Company nor any of its
          subsidiaries has received any notice of proceedings relating to the
          revocation or modification of any such Governmental Licenses which,
          singly or in the aggregate, if the subject of an unfavorable decision,
          ruling or finding, would result in a Material Adverse Effect.

               (xx) Title to Property. The Company and its subsidiaries have
          good and marketable title to all real property owned by the Company
          and its subsidiaries and good title to all other properties owned by
          them, in each case, free and clear of all mortgages, pledges, liens,
          security interests, claims, restrictions or encumbrances of any kind
          except such as (a) are described in the Offering Memorandum or (b)
          would not, singly or in the aggregate, have a Material Adverse Effect
          and, except as would not have a Material Adverse Effect, all of the
          leases and subleases material to the business of the Company and its
          subsidiaries, considered as one enterprise, and under which the
          Company or any of its subsidiaries holds properties described in the
          Offering Memorandum, are in full force and effect, and neither the
          Company nor any of its subsidiaries has any notice of any material
          claim of any sort that has been asserted by anyone adverse to the
          rights of the Company or any of its subsidiaries under any of the
          leases or subleases mentioned above, or affecting or questioning the
          rights of the Company or any subsidiary thereof to the continued
          possession of the leased or subleased premises under any such lease or
          sublease except for such claims as would not have a Material Adverse
          Effect.

               (xxi) Environmental Laws. Except as described in the Offering
          Memorandum and except such matters as would not, singly or in the
          aggregate, result in a Material Adverse Effect, (A) neither the
          Company nor any of its subsidiaries is in violation of any federal,
          state, local or foreign statute, law, rule, regulation, ordinance,
          code, policy or rule of common law or any judicial or ad-

                                      -8-

<PAGE>

          ministrative interpretation thereof, including any judicial or
          administrative order, consent, decree or judgment, relating to
          pollution or protection of human health, the environment (including,
          without limitation, ambient air, surface water, groundwater, land
          surface or subsurface strata) or wildlife, including, without
          limitation, laws and regulations relating to the release or threatened
          release of chemicals, pollutants, contaminants, wastes, toxic
          substances, hazardous substances, petroleum or petroleum products
          (collectively, "Hazardous Materials") or to the manufacture,
          processing, distribution, use, treatment, storage, disposal, transport
          or handling of Hazardous Materials (collectively, "Environmental
          Laws"), (B) the Company and its subsidiaries have all permits,
          authorizations and approvals required under any applicable
          Environmental Laws and are each in compliance with their requirements,
          (C) there are no pending or, to the knowledge of the Company
          threatened, administrative, regulatory or judicial actions, suits,
          demands, demand letters, claims, liens, notices of noncompliance or
          violation, investigation or proceedings relating to any Environmental
          Law against the Company or any of its subsidiaries and (D) there are
          no events or circumstances that might reasonably be expected to form
          the basis of an order for clean-up or remediation, or an action, suit
          or proceeding by any private party or governmental body or agency,
          against or affecting the Company or any of its subsidiaries relating
          to Hazardous Materials or Environmental Laws.

               (xxii) Investment Company Act. The Company is not, and upon the
          issuance and sale of the Securities as herein contemplated and the
          application of the net proceeds therefrom as described in the Offering
          Memorandum will not be, an "investment company" or an entity
          "controlled" by an "investment company" as such terms are defined in
          the Investment Company Act of 1940, as amended (the "1940 Act").

               (xxiii) Similar Offerings. Neither the Company nor any of its
          affiliates, as such term is defined in Rule 501(b) under the 1933 Act
          (each, an "Affiliate"), has, directly or indirectly, solicited any
          offer to buy, sold or offered to sell or otherwise negotiated in
          respect of, or will solicit any offer to buy, sell or offer to sell or
          otherwise negotiate in respect of, in the United States or to any
          United States citizen or resident, any security which is or would be
          integrated with the sale of the Original Securities in a manner that
          would require the Original Securities to be registered under the 1933
          Act.

               (xxiv) Rule 144A Eligibility. Subject to compliance by the
          Initial Purchasers with the representations and warranties set forth
          in Section 2 and the procedures set forth in Section 6 hereof, the
          Original Securities are eligible for resale pursuant to Rule 144A and
          will not be, at the Closing Time, of the same class as securities
          listed on a national securities exchange registered under Section 6 of
          the 1934 Act, or quoted in a U.S. automated interdealer quotation
          system.

               (xxv) No General Solicitation. None of the Company, its
          Affiliates or any person acting on its or any of their behalf (other
          than the Initial Purchasers, as to whom the Company makes no
          representation) has engaged or will engage, in

                                      -9-

<PAGE>

          connection with the offering of the Original Securities, in any form
          of general solicitation or general advertising within the meaning of
          Rule 502(c) under the 1933 Act.

               (xxvi) No Registration Required. Subject to compliance by the
          Initial Purchasers with the representations and warranties set forth
          in Section 2 and the procedures set forth in Section 6 hereof and
          compliance by all Subsequent Purchasers with the "Notice to Investors"
          section in the Offering Memorandum, it is not necessary in connection
          with the offer, sale and delivery of the Original Securities to the
          Initial Purchasers and to each Subsequent Purchaser in the manner
          contemplated by this Agreement and the Offering Memorandum to register
          the Original Securities under the 1933 Act or to qualify the Indenture
          under the Trust Indenture Act of 1939, as amended (the "1939 Act").

               (xxvii) Reporting Company. The Company is subject to the
          reporting requirements of Section 13 or Section 15(d) of the 1934 Act.

               (xxviii) Regulations T, U and X. None of the Company or any agent
          acting on its behalf has taken or will take any action that is
          reasonably likely to cause the issuance or sale of the Securities to
          violate Regulation T, U or X of the Board of Governors of the Federal
          Reserve System, in each case as in effect on the date hereof.

               (xxix) Medicare and Medicaid. To the extent described in the
          Offering Memorandum and except as otherwise described in the Offering
          Memorandum, all facilities owned, operated or managed as continuing
          operations by the Company (A) are licensed, to the extent necessary,
          under appropriate state laws to conduct the business as described in
          the Offering Memorandum, except as would not result in a Material
          Adverse Effect; (B) are certified for participation or enrollment in
          the Medicare and Medicaid programs; (C) have the benefit of a current
          and valid provider contract with the Medicare and Medicaid programs;
          and (D) are substantial compliance with the terms and conditions of
          participation in such programs and have received all approvals or
          qualifications necessary for reimbursement, except, in each case,
          where the failure to be so licensed or certified, to have the benefit
          of such contracts, to be in such compliance or to have such approvals
          or qualifications, singly or in the aggregate, would not have a
          Material Adverse Effect. To the knowledge of the Company, the amounts
          established as provisions for Medicare and Medicaid adjustments and
          adjustments by any other third party payors on the financial
          statements of the Company are sufficient in all material respects to
          pay any amounts for which the Company may be liable for such
          adjustments. Except as described in the Offering Memorandum, the
          Company has not received notice from the regulatory authorities which
          enforce the statutory or regulatory provisions in respect of the
          Medicare or Medicaid programs of any pending or threatened
          investigations, surveys (other than routine surveys) or
          decertification proceedings are pending, threatened or imminent, in
          each case, except such notices or threatened investigations, surveys
          or proceedings which singly or in the aggregate would not have a
          Material Adverse Effect.

                                      -10-

<PAGE>

               (xxx) Internal Accounting Controls. The Company and its
          Designated Subsidiaries maintain a system of internal accounting
          controls sufficient to provide reasonable assurances that (A)
          transactions are executed in accordance with management's general or
          specific authorization, (B) transactions are recorded as necessary to
          permit preparation of financial statements in conformity with
          generally accepted accounting principles and to maintain
          accountability for assets, (C) access to assets is permitted only in
          accordance with management's general or specific authorization and (D)
          the recorded accountability for assets is compared with the existing
          assets at reasonable intervals and appropriate action is taken with
          respect to any differences.

               (xxxi) Insurance. The Company and its subsidiaries carry or are
          entitled to the benefits of insurance in such amounts and covering
          such risks as is generally maintained by companies of established
          repute engaged in the same or similar business, and all such insurance
          is in full force and effect except for failures to have such insurance
          in full force and effect or to carry and be entitled to benefits of
          insurance which would not have a Material Adverse Effect.

          (b) Officer's Certificates. Any certificate signed by any officer of
the Company or any of its subsidiaries delivered to the Representatives or to
counsel for the Initial Purchasers shall be deemed a representation and warranty
by the Company to each Initial Purchaser as to the matters covered thereby.

          SECTION 2. Sale and Delivery to Initial Purchasers; Closing.

          (a) Securities. On the basis of the representations and warranties
herein contained and subject to the terms and conditions herein set forth, the
Company agrees to sell to each Initial Purchaser, severally and not jointly, and
each Initial Purchaser, severally and not jointly, agrees to purchase from the
Company, at the price set forth in Schedule B, the aggregate principal amount of
Original Securities set forth in Schedule A opposite the name of such Initial
Purchaser, plus any additional principal amount of Original Securities which
such Initial Purchaser may become obligated to purchase pursuant to the
provisions of Section 11 hereof.

          (b) Payment. Payment of the purchase price for, and delivery of
certificates for, the Original Securities shall be made at the office of Cahill
Gordon & Reindel LLP, 80 Pine Street, New York, New York 10005, or at such other
place as shall be agreed upon by the Representatives and the Company, at 9:00
A.M. (eastern time) on the third business day after the date hereof (unless
postponed in accordance with the provisions of Section 11), or such other time
not later than ten business days after such date as shall be agreed upon by the
Representatives and the Company (such time and date of payment and delivery
being herein called the "Closing Time"). Payment shall be made to the Company by
wire transfer of immediately available funds to a bank account designated by the
Company, against delivery to the Representatives for the respective accounts of
the Initial Purchasers of certificates for the Original Securities. It is
understood that each Initial Purchaser has authorized the Representatives, for
its account, to accept delivery of, receipt for, and make payment of the
purchase price for, the Original Securities which it has agreed to purchase.
Merrill Lynch, individually and not as representative of the Initial Purchasers,
may (but shall not be obligated to) make payment of the purchase price for the

                                      -11-

<PAGE>

Original Securities to be purchased by any Initial Purchaser whose funds have
not been received by the Closing Time, but such payment shall not relieve such
Initial Purchaser from its obligations hereunder.

          (c) Denominations; Registration. Certificates for the Original
Securities shall be in such denominations ($100,000 or integral multiples of
$1,000 in excess thereof) and registered in such names as the Representatives
may request in writing at least one full business day before the Closing Time.
The certificates representing the Original Securities shall be made available
for examination and packaging by the Initial Purchasers in The City of New York
not later than 10:00 A.M. on the last business day prior to the Closing Time.

          SECTION 3. Covenants of the Company. The Company covenants with each
Initial Purchaser as follows:

          (a) Offering Memorandum. The Company, as promptly as possible, will
furnish to each Initial Purchaser, without charge, such number of copies of the
Preliminary Offering Memorandum, the Final Offering Memorandum and any
amendments and supplements thereto and documents incorporated by reference
therein as such Initial Purchaser may reasonably request.

          (b) Notice and Effect of Material Events. The Company will notify each
Initial Purchaser, and confirm such notice in writing, of (x) any filing made by
the Company of information relating to the offering of the Original Securities
with any securities exchange or any other regulatory body in the United States
or any other jurisdiction, and (y) prior to the completion of the placement of
the Original Securities by the Initial Purchasers as evidenced by a notice in
writing from the Initial Purchasers to the Company, any material changes in or
affecting the condition, financial or otherwise, or the earnings or business
affairs of the Company and its subsidiaries considered as one enterprise which
(i) make any statement in the Offering Memorandum false or misleading or (ii)
are not disclosed in the Offering Memorandum. In such event or if during such
time any event shall occur as a result of which it is necessary, in the
reasonable opinion of any of the Company, its counsel, the Initial Purchasers or
counsel for the Initial Purchasers, to amend or supplement the Final Offering
Memorandum in order that the Final Offering Memorandum not include any untrue
statement of a material fact or omit to state a material fact necessary in order
to make the statements therein not misleading in the light of the circumstances
then existing, the Company will forthwith amend or supplement the Final Offering
Memorandum by preparing and furnishing to each Initial Purchaser an amendment or
amendments of, or a supplement or supplements to, the Final Offering Memorandum
(in form and substance satisfactory in the reasonable opinion of counsel for the
Initial Purchasers) so that, as so amended or supplemented, the Final Offering
Memorandum will not include an untrue statement of a material fact or omit to
state a material fact necessary in order to make the statements therein, in the
light of the circumstances existing at the time it is delivered to a Subsequent
Purchaser, not misleading.

          (c) Amendment to Offering Memorandum and Supplements. The Company will
advise each Initial Purchaser promptly of any proposal to amend or supplement
the Offering Memorandum and will not effect such amendment or supplement without
the consent of the Initial Purchasers, which consent will not be unreasonably
withheld. Neither the consent of the Ini-

                                      -12-

<PAGE>

tial Purchasers, nor the Initial Purchasers' delivery of any such amendment or
supplement, shall constitute a waiver of any of the conditions set forth in
Section 5 hereof.

          (d) Qualification of Securities for Offer and Sale. The Company will
use its reasonable best efforts, in cooperation with the Initial Purchasers, to
qualify the Original Securities for offering and sale under the applicable
securities laws of such states and other jurisdictions as the Representatives
may designate and will maintain such qualifications in effect as long as
required for the sale of the Original Securities; provided, however, that the
Company shall not be obligated to file any general consent to service of process
or to qualify as a foreign corporation or as a dealer in securities in any
jurisdiction in which it is not so qualified or to subject itself to taxation in
respect of doing business in any jurisdiction in which it is not otherwise so
subject.

          (e) Rating of Securities. The Company shall take all reasonable action
necessary to enable Standard & Poor's Ratings Services, a division of McGraw
Hill, Inc. ("S&P"), and Moody's Investors Service Inc. ("Moody's") to provide
their respective credit ratings of the Original Securities.

          (f) DTC. The Company will cooperate with the Representatives and use
its reasonable best efforts to permit the Original Securities to be eligible for
clearance and settlement through the facilities of DTC.

          (g) Use of Proceeds. The Company will use the net proceeds received by
it from the sale of the Original Securities in the manner specified in the
Offering Memorandum under "Use of Proceeds".

          (h) Restriction on Sale of Securities. During a period of 60 days from
the date of the Offering Memorandum, the Company will not, without the prior
written consent of Merrill Lynch, commence a public offering under the 1933 Act
or a private offering under Rule 144A of any other debt securities of the
Company that are substantially similar to the Securities.

          (i) PORTAL Designation. The Company will use its reasonable best
efforts to permit the Original Securities to be designated PORTAL securities in
accordance with the rules and regulations adopted by the National Association of
Securities Dealers, Inc. ("NASD") relating to trading in the PORTAL Market.

          (j) Reporting Requirements. The Company, during the period when the
Offering Memorandum is required to be delivered pursuant to Section 6(a)(vii)
hereof, will file all documents required to be filed with the Commission
pursuant to the 1934 Act within the time periods required by the 1934 Act and
the 1934 Act Regulations.

          SECTION 4. Payment of Expenses.

          (a) Expenses. The Company will pay all expenses incident to the
performance of its obligations under this Agreement, including (i) the
preparation, printing, delivery to the Initial Purchasers and any filing of the
Offering Memorandum (including financial statements and any schedules or
exhibits and any document incorporated therein by reference) and of each
amendment or supplement thereto, (ii) the preparation, printing and delivery to
the Initial Pur-

                                      -13-

<PAGE>

chasers of this Agreement, any Agreement among Initial Purchasers, the Indenture
and such other documents as may be required in connection with the offering,
purchase, sale, issuance or delivery of the Original Securities, (iii) the
preparation, issuance and delivery of the certificates for the Original
Securities to the Initial Purchasers, including any transfer taxes, any stamp or
other duties payable upon the sale, issuance and delivery of the Securities to
the Initial Purchasers and any charges of DTC in connection therewith, (iv) the
fees and disbursements of the Company's counsel, accountants and other advisors,
(v) the qualification of the Original Securities under securities laws in
accordance with the provisions of Section 3(d) hereof, including filing fees and
the reasonable fees and disbursements of counsel for the Initial Purchasers in
connection therewith and in connection with the preparation of the Blue Sky
survey, and any supplement thereto, (vi) the reasonable fees and expenses of the
Trustee, including the reasonable fees and disbursements of counsel for the
Trustee in connection with the Indenture and the Securities, and (vii) any fees
payable in connection with the rating of the Securities, and (viii) any fees and
expenses payable in connection with the initial and continued designation of the
Securities as PORTAL securities under the PORTAL Market Rules pursuant to NASD
Rule 5322; provided, however, that, except as provided in Sections 4(b), 7 and 8
hereof, the Initial Purchasers will pay all of their own costs and expenses,
including the fees and expenses of their counsel, transfer taxes on any resale
of the Securities by them and any advertising expenses in connection with any
offers they make.

          (b) Termination of Agreement. If this Agreement is terminated by the
Representatives in accordance with the provisions of Section 5 or Section
10(a)(i) hereof or by the Company in accordance with the provisions of Section
10(b) hereof, the Company shall reimburse the Initial Purchasers for all of
their reasonable out-of-pocket expenses, including the reasonable fees and
disbursements of counsel for the Initial Purchasers.

          SECTION 5. Conditions of Initial Purchasers' Obligations. The
obligations of the several Initial Purchasers hereunder are subject to the
accuracy of the representations and warranties of the Company contained in
Section 1 hereof and in certificates of any officer of the Company or any of its
subsidiaries delivered pursuant to the provisions hereof, to the performance by
the Company of its covenants and other obligations hereunder, and to the
following further conditions:

          (a) Opinion of Counsel for Company. At the Closing Time, the
Representatives shall have received the favorable opinion, dated as of the
Closing Time, of Dewey Ballantine LLP, counsel for the Company, and Donald P.
Fay, General Counsel for the Company, in form and substance reasonably
satisfactory to counsel for the Initial Purchasers, together with signed or
reproduced copies of such letter for each of the other Initial Purchasers
substantially to the effect set forth in Exhibits A-1 and A-2 hereto and to such
further effect as counsel to the Initial Purchasers may reasonably request.

          (b) Opinion of Counsel for Initial Purchasers. At the Closing Time,
the Representatives shall have received the favorable opinion, dated as of the
Closing Time, of Cahill Gordon & Reindel LLP, counsel for the Initial
Purchasers, together with signed or reproduced copies of such letter for each of
the other Initial Purchasers with respect to the matters set forth in (i), (ii),
(vi) through (x), inclusive, (xvii) and the penultimate paragraph of Exhibit A-1
hereto. In giving such opinion such counsel may rely, as to all matters governed
by the laws of jurisdic-

                                      -14-

<PAGE>

tions other than the law of the State of New York and the federal law of the
United States and the General Corporation Law of the State of Delaware, upon the
opinions of counsel satisfactory to the Representatives. Such counsel may also
state that, insofar as such opinion involves factual matters, they have relied,
to the extent they deem proper, upon certificates of officers of the Company and
its subsidiaries and certificates of public officials.

          (c) Officers' Certificate. At the Closing Time, there shall not have
been, since the date hereof or since the respective dates as of which
information is given in the Offering Memorandum, any material adverse change in
the condition, financial or otherwise, or in the earnings or business affairs of
the Company and its subsidiaries considered as one enterprise, whether or not
arising in the ordinary course of business, and the Representatives shall have
received a certificate of the President or a Vice President of the Company and
of the chief financial or chief accounting officer of the Company, dated as of
the Closing Time, to the effect that (i) there has been no such material adverse
change, (ii) the representations and warranties in Section 1 hereof are true and
correct with the same force and effect as though expressly made at and as of the
Closing Time, and (iii) the Company has complied with all agreements and
satisfied all conditions on its part to be performed or satisfied at or prior to
the Closing Time.

          (d) Accountants' Comfort Letter. At the time of the execution of this
Agreement, the Representatives shall have received from Ernst & Young LLP a
letter dated such date, in form and substance satisfactory to the
Representatives, together with signed or reproduced copies of such letter for
each of the other Initial Purchasers containing statements and information of
the type ordinarily included in accountants' "comfort letters" to Initial
Purchasers with respect to the financial statements and certain financial
information contained in the Offering Memorandum.

          (e) Bring-down Comfort Letter. At the Closing Time, the
Representatives shall have received from Ernst & Young LLP a letter, dated as of
the Closing Time, to the effect that they reaffirm the statements made in the
letter furnished pursuant to subsection (d) of this Section, except that the
specified date referred to shall be a date not more than three business days
prior to the Closing Time.

          (f) Rating. At the Closing Time, the Original Securities shall be
rated at least "B3" by Moody's and "B" by S&P, and the Company shall have
delivered to the Representatives a letter dated the Closing Time, from each such
rating agency, or other evidence satisfactory to the Representatives, confirming
that the Original Securities have such ratings; and since the date of this
Agreement, there shall not have occurred a downgrading in the rating assigned to
the Original Securities or any of the Company's other debt securities by any
"nationally recognized statistical rating agency", as that term is defined by
the Commission for purposes of Rule 436(g)(2) under the 1933 Act, and no such
securities rating agency shall have publicly announced that it has under
surveillance or review, with possible negative implications, its rating of the
Original Securities or any of the Company's other debt securities.

          (g) PORTAL. At the Closing Time, the Original Securities shall have
been designated for trading on PORTAL.

                                      -15-

<PAGE>

          (h) Additional Documents. At the Closing Time, counsel for the Initial
Purchasers shall have been furnished with such documents and opinions as they
may reasonably require for the purpose of enabling them to pass upon the
issuance and sale of the Securities as herein contemplated, or in order to
evidence the accuracy of any of the representations or warranties, or the
fulfillment of any of the conditions, herein contained; and all proceedings
taken by the Company in connection with the issuance and sale of the Securities
as herein contemplated shall be reasonably satisfactory in form and substance to
the Representatives and counsel for the Initial Purchasers.

          (i) Termination of Agreement. If any condition specified in this
Section 5 shall not have been fulfilled when and as required to be fulfilled,
this Agreement may be terminated by the Representatives by notice to the Company
at any time at or prior to the Closing Time, and such termination shall be
without liability of any party to any other party except as provided in Section
4 and except that Sections 1, 7, 8 and 14 shall survive any such termination and
remain in full force and effect.

          SECTION 6. Subsequent Offers and Resales of the Securities.

          (a) Offer and Sale Procedures. Each of the Initial Purchasers and the
Company hereby establish and agree to observe the following procedures in
connection with the offer and sale of the Original Securities:

               (i) Offers and Sales only to Qualified Institutional Buyers.
          Offers and sales of the Original Securities shall only be made to
          persons whom the offeror or seller reasonably believes to be qualified
          institutional buyers, as defined in Rule 144A under the 1933 Act
          ("Qualified Institutional Buyers"). Each Initial Purchaser severally
          agrees that it will not offer, sell or deliver any of the Original
          Securities in any jurisdiction outside the United States.

               (ii) No General Solicitation. No general solicitation or general
          advertising (within the meaning of Rule 502(c) under the 1933 Act)
          will be used in the United States in connection with the offering or
          sale of the Original Securities.

               (iii) Purchases by Non-Bank Fiduciaries. In the case of a
          non-bank Subsequent Purchaser of an Original Security acting as a
          fiduciary for one or more third parties, each third party shall, in
          the judgment of the applicable Initial Purchaser, be a Qualified
          Institutional Buyer.

               (iv) Subsequent Purchaser Notification. Each Initial Purchaser
          will take reasonable steps to inform, and cause each of its U.S.
          Affiliates to take reasonable steps to inform, persons acquiring
          Original Securities from such Initial Purchaser or affiliate, as the
          case may be, in the United States that the Original Securities (A)
          have not been and will not be registered under the 1933 Act, (B) are
          being sold to them without registration under the 1933 Act in reliance
          on Rule 144A or in accordance with another exemption from registration
          under the 1933 Act, as the case may be, and (C) may not be offered,
          sold or otherwise transferred except (1) to the Company, (2) outside
          the United States in accordance with

                                      -16-

<PAGE>

          Regulation S, or (3) inside the United States in accordance with (x)
          Rule 144A to a person whom the seller reasonably believes is a
          Qualified Institutional Buyer that is purchasing such Original
          Securities for its own account or for the account of a Qualified
          Institutional Buyer to whom notice is given that the offer, sale or
          transfer is being made in reliance on Rule 144A or (y) pursuant to
          another available exemption from registration under the 1933 Act.

               (v) Minimum Principal Amount. No sale of the Securities to any
          one Subsequent Purchaser will be for less than US$100,000 principal
          amount and no Security will be issued in a smaller principal amount.
          If the Subsequent Purchaser is a non-bank fiduciary acting on behalf
          of others, each person for whom it is acting must purchase at least
          US$100,000 principal amount of the Securities.

               (vi) Restrictions on Transfer. The transfer restrictions and the
          other provisions set forth in the Offering Memorandum under the
          heading "Notice to Investors", including the legend required thereby,
          shall apply to the Original Securities except as otherwise agreed by
          the Company and the Initial Purchasers.

               (vii) Delivery of Offering Memorandum. Each Initial Purchaser
          will deliver to each purchaser of the Original Securities from such
          Initial Purchaser, in connection with its original distribution of the
          Original Securities, a copy of the Offering Memorandum, as amended and
          supplemented at the date of such delivery.

          (b) Covenants of the Company. The Company covenants with each Initial
Purchaser as follows:

               (i) Integration. The Company agrees that it will not and will
          cause its Affiliates not to, directly or indirectly, solicit any offer
          to buy, sell or make any offer or sale of, or otherwise negotiate in
          respect of, securities of the Company of any class if, as a result of
          the doctrine of "integration" referred to in Rule 502 under the 1933
          Act, such offer or sale would render invalid (for the purpose of (i)
          the sale of the Original Securities by the Company to the Initial
          Purchasers, (ii) the resale of the Original Securities by the Initial
          Purchasers to Subsequent Purchasers or (iii) the resale of the
          Original Securities by such Subsequent Purchasers to others) the
          exemption from the registration requirements of the 1933 Act provided
          by Section 4(2) thereof or by Rule 144A or by Regulation S thereunder
          or otherwise.

               (ii) Rule 144A Information. The Company agrees that, in order to
          render the Original Securities eligible for resale pursuant to Rule
          144A under the 1933 Act, while any of the Original Securities remain
          outstanding, it will make available, upon request, to any holder of
          Securities or prospective purchasers of Original Securities the
          information specified in Rule 144A(d)(4), unless the Company furnishes
          information to the Commission pursuant to Section 13 or 15(d) of the
          1934 Act.

                                      -17-

<PAGE>

               (iii) Restriction on Repurchases. Until the earlier of two years
          after the original issuance of the Original Securities or the date
          that all of the Original Securities shall have been exchanged for
          Exchange Securities the Company will not, and will cause its
          Affiliates not to, resell any Original Securities which are
          "restricted securities" (as such term is defined under Rule 144(a)(3)
          under the 1933 Act), whether as beneficial owner or otherwise (except
          as agent acting as a securities broker on behalf of and for the
          account of customers in the ordinary course of business in unsolicited
          broker's transactions) unless, immediately upon any such purchase, the
          Company or any Affiliate of the Company shall submit such Original
          Securities to the Trustee for cancellation.

          (c) Qualified Institutional Buyer. Each Initial Purchaser severally
and not jointly represents and warrants to, and agrees with, the Company that it
is a "qualified institutional buyer" within the meaning of Rule 144A under the
1933 Act (a "Qualified Institutional Buyer") and an "accredited investor" within
the meaning of Rule 501(a) under the 1933 Act (an "Accredited Investor").

          (d) Resale Pursuant to Rule 144A. Each Initial Purchaser understands
that the Original Securities have not been and will not be registered under the
1933 Act and may not be offered or sold within the United States except pursuant
to an exemption from, or in a transaction not subject to, the registration
requirements of the 1933 Act. Each Initial Purchaser severally represents and
agrees that it has not offered or sold, and will not offer or sell, any Original
Securities constituting part of its allotment within the United States except in
accordance with Rule 144A under the Securities Act or another applicable
exemption from the registration requirements of the 1933 Act.

          (e) Additional Representations and Warranties of Initial Purchasers.
Each Initial Purchaser severally represents and agrees that it has not entered
and will not enter into any contractual arrangements with respect to the
distribution of the Original Securities, except with its affiliates or with the
prior written consent of the Company.

          SECTION 7. Indemnification.

          (a) Indemnification of Initial Purchasers. The Company agrees to
indemnify and hold harmless each Initial Purchaser and each person, if any, who
controls any Initial Purchaser within the meaning of Section 15 of the 1933 Act
or Section 20 of the 1934 Act as follows:

               (i) against any and all loss, liability, claim, damage and
          expense whatsoever, as incurred, arising out of any untrue statement
          or alleged untrue statement of a material fact contained in any
          Preliminary Offering Memorandum or the Final Offering Memorandum (or
          any amendment or supplement thereto), or the omission or alleged
          omission therefrom of a material fact necessary in order to make the
          statements therein, in the light of the circumstances under which they
          were made, not misleading;

                                      -18-

<PAGE>

               (ii) against any and all loss, liability, claim, damage and
          expense whatsoever, as incurred, to the extent of the aggregate amount
          paid in settlement of any litigation, or any investigation or
          proceeding by any governmental agency or body, commenced or
          threatened, or of any claim whatsoever based upon any such untrue
          statement or omission, or any such alleged untrue statement or
          omission; provided that (subject to Section 7(d) below) any such
          settlement is effected with the prior written consent of the Company;
          and

               (iii) against any and all expense whatsoever, as incurred
          (including the reasonable fees and disbursements of counsel chosen by
          Merrill Lynch), reasonably incurred in investigating, preparing or
          defending against any litigation, or any investigation or proceeding
          by any governmental agency or body, commenced or threatened, or any
          claim whatsoever based upon any such untrue statement or omission, or
          any such alleged untrue statement or omission, to the extent that any
          such expense is not paid under (i) or (ii) above;

provided, however, that this indemnity agreement shall not apply to any loss,
liability, claim, damage or expense to the extent arising out of any untrue
statement or omission or alleged untrue statement or omission made in reliance
upon and in conformity with written information furnished to the Company by any
Initial Purchaser through the Representatives expressly for use in the Offering
Memorandum (or any amendment thereto).

          (b) Indemnification of Company. Each Initial Purchaser severally
agrees to indemnify and hold harmless the Company, each officer or director of
the Company, and each person, if any, who controls the Company within the
meaning of Section 15 of the 1933 Act or Section 20 of the 1934 Act against any
and all loss, liability, claim, damage and expense described in the indemnity
contained in subsection (a) of this Section, as incurred, but only with respect
to untrue statements or omissions, or alleged untrue statements or omissions,
made in the Offering Memorandum in reliance upon and in conformity with written
information furnished to the Company by such Initial Purchaser through the
Representatives expressly for use in the Offering Memorandum.

          (c) Actions against Parties; Notification. Each indemnified party
shall give notice as promptly as reasonably practicable to each indemnifying
party of any action commenced against it in respect of which indemnity may be
sought hereunder, but failure to so notify an indemnifying party shall not
relieve such indemnifying party from any liability hereunder to the extent it is
not materially prejudiced as a result thereof and in any event shall not relieve
it from any liability which it may have otherwise than on account of this
indemnity agreement. In the case of parties indemnified pursuant to Section 7(a)
above, counsel to the indemnified parties shall be selected by Merrill Lynch,
and, in the case of parties indemnified pursuant to Section 7(b) above, counsel
to the indemnified parties shall be selected by the Company. An indemnifying
party may participate at its own expense in the defense of any such action and,
to the extent that the indemnifying party may wish, assume the defense of any
such action, with counsel reasonably satisfactory to the indemnified party, and
after notice from the indemnifying party to the indemnified party of its
election to assume the defense of such action, the indemnifying party will not
be liable to such indemnified party under this Section 7 for any legal or other
expenses subsequently incurred by the indemnified party in connection with the
defense of such action

                                      -19-

<PAGE>

other than reasonable costs of investigation; provided, however, that counsel to
the indemnifying party shall not (except with the consent of the indemnified
party) also be counsel to the indemnified party. In no event shall the
indemnifying parties be liable for fees and expenses of more than one counsel
(in addition to any local counsel) separate from their own counsel for all
indemnified parties in connection with any one action or separate but similar or
related actions in the same jurisdiction arising out of the same general
allegations or circumstances. No indemnifying party shall, without the prior
written consent of the indemnified parties, settle or compromise or consent to
the entry of any judgment with respect to any litigation, or any investigation
or proceeding by any governmental agency or body, commenced or threatened, or
any claim whatsoever in respect of which indemnification or contribution could
be sought under this Section 7 or Section 8 hereof (whether or not the
indemnified parties are actual or potential parties thereto), unless such
settlement, compromise or consent (i) includes an unconditional release of each
indemnified party from all liability arising out of such litigation,
investigation, proceeding or claim and (ii) does not include a statement as to
or an admission of fault, culpability or a failure to act by or on behalf of any
indemnified party. No indemnified party shall, without the prior written consent
of the indemnifying party (which consent shall not be unreasonably withheld),
settle or compromise or consent to the entry of any judgment with respect to any
litigation, or any investigation or proceeding by any governmental agency or
body, commenced or threatened, or any claim whatsoever in respect of which
indemnification or contribution could be sought under this Section 7 or Section
8 hereof.

          (d) Settlement without Consent if Failure to Reimburse. If at any time
an indemnified party shall have requested an indemnifying party to reimburse the
indemnified party for fees and expenses of counsel in accordance with Section
7(a)(iii), such indemnifying party agrees that it shall be liable for any
settlement of the nature contemplated by Section 7(a)(ii) effected without its
written consent if (i) such settlement is entered into more than 60 days after
receipt by such indemnifying party of the aforesaid request, (ii) such
indemnifying party shall have received notice of the terms of such settlement at
least 45 days prior to such settlement being entered into and (iii) such
indemnifying party shall not have reimbursed such indemnified party in
accordance with such request prior to the date of such settlement.

          SECTION 8. Contribution. If the indemnification provided for in
Section 7 hereof is for any reason unavailable to or insufficient to hold
harmless an indemnified party in respect of any losses, liabilities, claims,
damages or expenses referred to therein, then each indemnifying party shall
contribute to the aggregate amount of such losses, liabilities, claims, damages
and expenses incurred by such indemnified party, as incurred, (i) in such
proportion as is appropriate to reflect the relative benefits received by the
Company on the one hand and the Initial Purchasers on the other hand from the
offering of the Original Securities pursuant to this Agreement or (ii) if the
allocation provided by clause (i) is not permitted by applicable law, in such
proportion as is appropriate to reflect not only the relative benefits referred
to in clause (i) above but also the relative fault of the Company on the one
hand and of the Initial Purchasers on the other hand in connection with the
statements or omissions which resulted in such losses, liabilities, claims,
damages or expenses, as well as any other relevant equitable considerations.

          The relative benefits received by the Company on the one hand and the
Initial Purchasers on the other hand in connection with the offering of the
Original Securities pursuant to this Agreement shall be deemed to be in the same
respective proportions as the total net pro-

                                      -20-

<PAGE>

ceeds from the offering of the Original Securities pursuant to this Agreement
(before deducting expenses) received by the Company and the total underwriting
discount received by the Initial Purchasers, bear to the aggregate initial
offering price of the Original Securities.

          The relative fault of the Company on the one hand and the Initial
Purchasers on the other hand shall be determined by reference to, among other
things, whether any such untrue or alleged untrue statement of a material fact
or omission or alleged omission to state a material fact relates to information
supplied by the Company or by the Initial Purchasers and the parties' relative
intent, knowledge, access to information and opportunity to correct or prevent
such statement or omission.

          The Company and the Initial Purchasers agree that it would not be just
and equitable if contribution pursuant to this Section 8 were determined by pro
rata allocation (even if the Initial Purchasers were treated as one entity for
such purpose) or by any other method of allocation which does not take account
of the equitable considerations referred to above in this Section 8. The
aggregate amount of losses, liabilities, claims, damages and expenses incurred
by an indemnified party and referred to above in this Section 8 shall be deemed
to include any legal or other expenses reasonably incurred by such indemnified
party in investigating, preparing or defending against any litigation, or any
investigation or proceeding by any governmental agency or body, commenced or
threatened, or any claim whatsoever based upon any such untrue or alleged untrue
statement or omission or alleged omission.

          Notwithstanding the provisions of this Section 8, no Initial Purchaser
shall be required to contribute any amount in excess of the amount by which the
total price at which the Securities purchased and sold by it hereunder exceeds
the amount of any damages which such Initial Purchaser has otherwise been
required to pay by reason of such untrue or alleged untrue statement or omission
or alleged omission.

          No person guilty of fraudulent misrepresentation (within the meaning
of Section 11(f) of the 1933 Act) shall be entitled to contribution from any
person who was not guilty of such fraudulent misrepresentation.

          For purposes of this Section 8, each person, if any, who controls an
Initial Purchaser within the meaning of Section 15 of the 1933 Act or Section 20
of the 1934 Act shall have the same rights to contribution as such Initial
Purchaser, and each officer and director of the Company and each person, if any,
who controls the Company within the meaning of Section 15 of the 1933 Act or
Section 20 of the 1934 Act shall have the same rights to contribution as the
Company. The Initial Purchasers' respective obligations to contribute pursuant
to this Section 8 are several in proportion to the principal amount of Original
Securities set forth opposite their respective names in Schedule A hereto and
not joint.

          SECTION 9. Representations, Warranties and Agreements to Survive
Delivery. All representations, warranties and agreements contained in this
Agreement or in certificates of officers of the Company or any of its
subsidiaries submitted pursuant hereto shall remain operative and in full force
and effect, regardless of any investigation made by or on behalf of any Initial
Purchaser or controlling person, or by or on behalf of the Company, and shall
survive delivery of the Original Securities to the Initial Purchasers.

                                      -21-

<PAGE>

          SECTION 10. Termination of Agreement.

          (a) Termination; General. The Representatives may terminate this
Agreement, by notice to the Company, at any time at or prior to Closing Time (i)
if there has been, since the time of execution of this Agreement or since the
respective dates as of which information is given in the Offering Memorandum
(exclusive of any supplement thereto), any material adverse change in the
condition, financial or otherwise, or in the earnings or business affairs of the
Company and its subsidiaries considered as one enterprise, whether or not
arising in the ordinary course of business, or (ii) if there has occurred any
material adverse change in the financial markets in the United States or in the
international financial markets, any outbreak of hostilities or escalation
thereof or other calamity or crisis or any change or development involving a
prospective change in national or international political, financial or economic
conditions, in each case the effect of which is such as to make it, in the
judgment of the Representatives, impracticable or inadvisable to market the
Original Securities or to enforce contracts for the sale of the Original
Securities, or (iii) if trading in any securities of the Company has been
suspended or materially limited by the Commission or the New York Stock
Exchange, or if trading generally on the American Stock Exchange or the New York
Stock Exchange or in the Nasdaq National Market has been suspended or materially
limited, or minimum or maximum prices for trading have been fixed, or maximum
ranges for prices have been required, by any of said exchanges or by such system
or by order of the Commission, the National Association of Securities Dealers,
Inc. or any other governmental authority, or a material disruption has occurred
in commercial banking or securities settlement or clearance services in the
United States, or (iv) if a banking moratorium has been declared by either
Federal or New York authorities.

          (b) Termination; Tender Offer. It is understood that the obligation of
the Company to sell the Securities being sold by them hereunder is subject to
the condition that the Company accept 11% Senior Subordinated Notes due 2009 for
purchase in the tender offer that the Company commenced on October 27, 2003. If
the Company does not accept 11% Senior Subordinated Notes for purchase in such
tender offer, this Agreement may be terminated by the Company upon notice to the
Initial Purchasers at or prior to the Closing Time.

          (c) Liabilities. If this Agreement is terminated pursuant to this
Section 10, such termination shall be without liability of any party to any
other party except as provided in Section 4 hereof, and provided further that
Sections 1, 7, 8 and 14 shall survive such termination and remain in full force
and effect.

          SECTION 11. Default by One or More of the Initial Purchasers. If one
or more of the Initial Purchasers shall fail at the Closing Time to purchase the
Original Securities which it or they are obligated to purchase under this
Agreement (the "Defaulted Securities"), the Representatives shall have the
right, within 24 hours thereafter, to make arrangements for one or more of the
non-defaulting Initial Purchasers, or any other initial purchasers, to purchase
all, but not less than all, of the Defaulted Securities in such amounts as may
be agreed upon and upon the terms herein set forth; if, however, the
Representatives shall not have completed such arrangements within such 24-hour
period, then the Company shall have 24 hours to procure another purchaser of
Defaulted Securities satisfactory to the Representatives. If after arrangements
by the Representatives or the Company for the purchase of Defaulted Securities:

                                      -22-

<PAGE>

          (a) the number of Defaulted Securities does not exceed 10% of the
     aggregate principal amount of the Original Securities to be purchased
     hereunder, each of the non-defaulting Initial Purchasers shall be
     obligated, severally and not jointly, to purchase the full amount thereof
     in the proportions that their respective underwriting obligations hereunder
     bear to the underwriting obligations of all non-defaulting Initial
     Purchasers, or

          (b) the number of Defaulted Securities exceeds 10% of the aggregate
     principal amount of the Original Securities to be purchased hereunder, this
     Agreement shall terminate without liability on the part of any
     non-defaulting Initial Purchaser.

          No action taken pursuant to this Section 11 shall relieve any
defaulting Initial Purchaser from liability in respect of its default.

          In the event of any such default which does not result in a
termination of this Agreement, either the Representatives or the Company shall
have the right to postpone the Closing Time for a period not exceeding seven
days in order to effect any required changes in the Offering Memorandum or in
any other documents or arrangements. As used herein, the term "Initial
Purchaser" includes any person substituted for an Initial Purchaser under this
Section 11.

          SECTION 12. Notices. All notices and other communications hereunder
shall be in writing and shall be deemed to have been duly given if mailed or
transmitted by any standard form of telecommunication. Notices to the Initial
Purchasers shall be directed to the Representatives at Merrill Lynch, Pierce,
Fenner & Smith Incorporated, 4 World Financial Center, North Tower, New York,
New York 10080, attention of Jill Wallach, Esq. and Banc of America Securities
LLC, 9 West 57th Street, New York, New York 10019, attention of Ilana Wolfe,
Esq. with a copy to Noah B. Newitz at Cahill Gordon & Reindel LLP, 80 Pine
Street, New York, New York 10005; notices to the Company shall be directed to it
at 5800 Tennyson Parkway, Plano, Texas 75024, attention of General Counsel with
a copy to Morton A. Pierce and Michelle B. Rutta at Dewey Ballantine LLP, 1301
Avenue of the Americas, New York, New York 10019.

          SECTION 13. Parties. This Agreement shall inure to the benefit of and
be binding upon the Initial Purchasers and the Company and their respective
successors. Nothing expressed or mentioned in this Agreement is intended or
shall be construed to give any person, firm or corporation, other than the
Initial Purchasers and the Company and their respective successors and the
controlling persons and officers and directors referred to in Sections 7 and 8
and their heirs and legal representatives, any legal or equitable right, remedy
or claim under or in respect of this Agreement or any provision herein
contained. This Agreement and all conditions and provisions hereof are intended
to be for the sole and exclusive benefit of the Initial Purchasers and the
Company and their respective successors, and said controlling persons and
officers and directors and their heirs and legal representatives, and for the
benefit of no other person, firm or corporation. No purchaser of Securities from
any Initial Purchaser shall be deemed to be a successor by reason merely of such
purchase.

          SECTION 14. Tax Treatment. Notwithstanding anything to the contrary
contained herein, any confidentiality obligations of the Company and Initial
Purchasers that relate to the transactions contemplated by this and any other
related agreements (the "Transaction") shall not apply to the U.S. federal tax
treatment or U.S. federal tax structure of the Transaction and

                                      -23-

<PAGE>

each party hereto (and any employee, representative, or agent of any party) may
disclose to any and all persons, without limitation of any kind, the U.S.
federal tax treatment and U.S. federal tax structure of the Transaction and all
other materials of any kind (including opinions or other U.S. federal tax
analysis) that are provided to any party hereto relating to such U.S. federal
tax treatment and U.S. federal tax structure. However, any such information
relating to such U.S. federal tax treatment and U.S. federal tax structure is
required to be kept confidential to the extent necessary to comply with any
applicable securities laws. The preceding sentences are intended to cause the
Transaction not to be treated as having been offered under conditions of
confidentiality for purposes of Sections 1.6011-4(b)(3) and 301.6111-2(a)(2)(ii)
(or any successor provisions) of the Treasury Regulations issued under the
Internal Revenue Code of 1986, as amended, and shall be construed in a manner
consistent with such purpose.

          SECTION 15. GOVERNING LAW AND TIME. THIS AGREEMENT SHALL BE GOVERNED
BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. EXCEPT AS
OTHERWISE SET FORTH HEREIN, SPECIFIED TIMES OF DAY REFER TO NEW YORK CITY TIME.

          SECTION 16. Effect of Headings. The Article and Section headings
herein and the Table of Contents are for convenience only and shall not affect
the construction hereof.

          SECTION 17. Counterparts. This Agreement may be executed in any number
of counterparts and by the parties hereto in separate counterparts, each of
which when so executed shall be deemed to be an original and all of which taken
together shall constitute one and the same agreement.

                                      -24-

<PAGE>

          If the foregoing is in accordance with your understanding of our
agreement, please sign and return to the Company a counterpart hereof, whereupon
this instrument, along with all counterparts, will become a binding agreement
among the Initial Purchasers and the Company in accordance with its terms.

                                        Very truly yours,

                                        TRIAD HOSPITALS, INC.

                                        By:  /s/ Burke W. Whitman
                                            ------------------------------------
                                            Name: Burke W. Whitman
                                            Title: CFO

                                      -25-

<PAGE>

CONFIRMED AND ACCEPTED,
   as of the date first above written:

MERRILL LYNCH & CO.

MERRILL LYNCH, PIERCE, FENNER & SMITH
     INCORPORATED
BANC OF AMERICA SECURITIES LLC

By: Merrill Lynch, Pierce, Fenner & Smith
       Incorporated

     By: /s/ James Forbes
         ------------------------------------
         Name:  James Forbes
         Title: Managing Director

By: Banc of America Securities LLC

     By: /s/ Robert L. Parker
         ------------------------------------
         Name:  Robert L. Parker
         Title: MD

          For themselves and as Representatives of the other Initial Purchasers
named in Schedule A hereto.

                                      -26-

<PAGE>

                                   SCHEDULE A

                                                                     Principal
                                                                     Amount of
Name of Initial Purchaser                                            Securities
-------------------------                                           ------------
Merrill Lynch, Pierce, Fenner & Smith Incorporated...............   $144,000,000
Banc of America Securities LLC...................................   $114,000,000
Citigroup Global Markets Inc. ...................................   $ 40,000,000
Credit Suisse First Boston LLC ..................................   $ 40,000,000
Goldman, Sachs & Co. ............................................   $ 40,000,000
Credit Lyonnais Securities (USA) Inc. ...........................   $ 24,000,000
Fleet Securities, Inc. ..........................................   $ 24,000,000
J.P. Morgan Securities Inc. .....................................   $ 24,000,000
Scotia Capital (USA) Inc. .......................................   $ 24,000,000
SunTrust Capital Markets, Inc. ..................................   $ 24,000,000
Wachovia Capital Markets, LLC....................................   $ 24,000,000
Bear, Stearns & Co. Inc. ........................................   $ 18,000,000
Lehman Brothers Inc. ............................................   $ 18,000,000
Morgan Stanley & Co. Incorporated................................   $ 18,000,000
BOSC, Inc. ......................................................   $ 12,000,000
Stephens Inc. ...................................................   $ 12,000,000

                                                                    ------------
Total............................................................   $600,000,000
                                                                    ============

                                    Sch A-1

<PAGE>

                                   SCHEDULE B

                              TRIAD HOSPITALS, INC.
                 $600,000,000 Senior Subordinated Notes due 2013

          1. The initial public offering price of the Securities shall be 100%
of the principal amount thereof, plus accrued interest, if any, from the date of
issuance.

          2. The purchase price to be paid by the Initial Purchasers for the
Securities shall be 98.0% of the principal amount thereof.

          3. The interest rate on the Securities shall be 7.0% per annum.

          4. Prior to November 15, 2008, we may redeem all or any portion of the
Securities at a redemption price equal to 100% of the principal amount plus the
Applicable Premium described in the Offering Memorandum, plus accrued and unpaid
interest to the redemption date. We may redeem the Securities, in whole or in
part, at any time on or after November 15, 2008 at our option at the redemption
prices set forth in the Offering Memorandum under the heading "Description of
the Notes--Optional Redemption," plus accrued and unpaid interest to the
redemption date.

          5. On or before November 15, 2006, we may redeem up to 35% of the
Securities with the net proceeds of certain equity offerings at 107.0% of the
principal amount thereof, plus accrued interest, if at least 65% of the
aggregate principal amount of the originally issued Securities remain
outstanding.

                                    Sch B-1

<PAGE>

                                   SCHEDULE C

                              LIST OF SUBSIDIARIES

Triad Holdings III, LLC
Triad Holdings IV, LLC
Triad Holdings, V, LLC
Triad of Indiana, LLC
IOM Healthsystems, LP

                                    Sch C-1

<PAGE>

                                                                     Exhibit A-1

                      FORM OF OPINION OF COMPANY'S COUNSEL
                           TO BE DELIVERED PURSUANT TO
                                  SECTION 5(a)

     (i) The Company has been duly incorporated and is validly existing as a
corporation in good standing under the laws of the State of Delaware.

     (ii) The Company has corporate power and authority to own, lease and
operate its properties and to conduct its business as described in the Offering
Memorandum and to enter into and perform its obligations under the Purchase
Agreement.

     (iii) The Company is duly qualified as a foreign corporation to transact
business and is in good standing in each jurisdiction in which such
qualification is required, whether by reason of the ownership or leasing of
property or the conduct of business, except where the failure so to qualify or
to be in good standing would not result in a Material Adverse Effect.

     (iv) The shares of issued and outstanding capital stock of the Company have
been duly authorized and validly issued and are fully paid and non-assessable;
and none of the outstanding shares of capital stock of the Company was issued in
violation of the statutory preemptive rights of any stockholder of the Company.

     (v) Each Designated Subsidiary that is a Delaware corporation has been duly
incorporated and is validly existing as a corporation in good standing under the
laws of the jurisdiction of its incorporation, has corporate power and authority
to own, lease and operate its properties and to conduct its business as
described in the Offering Memorandum and is duly qualified as a foreign
corporation to transact business and is in good standing in each jurisdiction in
which such qualification is required, whether by reason of the ownership or
leasing of property or the conduct of business, except where the failure so to
qualify or to be in good standing would not result in a Material Adverse Effect;
except as otherwise disclosed in the Offering Memorandum, to our knowledge, all
of the issued and outstanding capital stock of each Designated Subsidiary that
is a Delaware corporation has been duly authorized and validly issued, is fully
paid and non-assessable and, to our knowledge, with respect to shares of such
capital stock owned directly or indirectly by the Company, are owned by the
Company, directly or through subsidiaries, free and clear of any security
interest, mortgage, pledge, lien, encumbrance, claim or equity other than those
under the Company's Senior Secured Credit Agreement (as defined in the Offering
Memorandum).

     (vi) The Purchase Agreement has been duly authorized, executed and
delivered by the Company.

     (vii) The Indenture has been duly authorized by the Company and, when
executed and delivered by the Company and the Trustee (assuming the due
authorization, execution and de-

                                      A-1-1

<PAGE>

livery thereof by the Trustee), will constitute a valid and binding agreement of
the Company, enforceable against the Company in accordance with its terms.

     (viii) The Registration Rights Agreement has been duly authorized by the
Company and, when executed and delivered by the Company (assuming the due
authorization, execution and delivery thereof by the parties thereto other than
the Company), will constitute a valid and binding agreement of the Company,
enforceable against the Company in accordance with its terms.

     (ix) The Original Securities have been duly authorized by the Company and,
when executed by the Company and authenticated, issued and delivered in the
manner provided in the Indenture (assuming the due authorization, execution and
delivery of the Indenture by the Trustee) against payment of the purchase price
therefor as provided in the Purchase Agreement, will constitute valid and
binding obligations of the Company, enforceable against the Company in
accordance with their terms.

     (x) The Exchange Securities have been duly and validly authorized by the
Company and, when executed, issued and delivered by the Company in exchange for
the Original Securities pursuant to the Exchange Offer in accordance with the
terms of the Registration Rights Agreement, will be valid and binding
obligations of the Company, enforceable against the Company in accordance with
their terms, and will be substantially in the form contemplated by, and entitled
to the benefits of, the Indenture.

     (xi) The documents incorporated by reference in the Offering Memorandum
(other than the financial statements and the notes thereto, and the other
financial data and statistical data derived from financial data therein and the
exhibits thereto as to which we render no opinion), when they were filed with
the Commission appeared on their face to comply as to form in all material
respects with the requirements of the 1934 Act and the rules and regulations of
the Commission thereunder.

     (xii) The statements made in the Final Offering Memorandum under the
caption "Material Federal Income Tax Considerations," insofar as they purport to
constitute a summary of United States federal tax law and regulations or legal
conclusions with respect thereto, constitute an accurate summary of the matters
described therein in all material respects.

     (xiii) The statements made in the Final Offering Memorandum under the
headings "Summary--The Offering," "Description of the Notes" and "Exchange
Offer; Registration Rights," insofar as they purport to constitute summaries of
the terms of contracts and other documents, constitute accurate summaries of the
terms of such contracts and other documents in all material respects.

     (xiv) To our knowledge, no filing with, or authorization, approval,
consent, license, order, registration, qualification or decree of, any United
States federal, New York or Delaware court or governmental authority or agency
is necessary or required for the due execution, delivery or performance by the
Company of the Indenture and the Registration Rights Agree-

                                      A-1-2

<PAGE>

ment for the offering, issuance or sale of the Securities to the Initial
Purchasers except (a) such as have already been obtained and are in full force
and effect, (b) in connection with the registration of the Exchange Securities
pursuant to the Registration Rights Agreement, (c) any filings under state
securities or Blue Sky laws in connection with the sale of the Securities, (d)
the qualification of the Indenture under the Trust Indenture Act in connection
with the Exchange Offer, (e) as disclosed in the Offering Memorandum and (f) for
such authorizations, approvals, consents, licenses, orders, registrations,
qualifications or decrees the failure so to obtain would not have a Material
Adverse Effect and would not materially and adversely affect the consummation of
the transactions contemplated by the Purchase Agreement, the Registration Rights
Agreement or the Indenture.

     (xv) Subject to compliance by the parties to the Purchase Agreement with
the representations, covenants and agreements therein, it is not necessary in
connection with the offer, sale and delivery of the Original Securities to the
Initial Purchasers and to each initial Subsequent Purchaser in the manner
contemplated by the Purchase Agreement and the Offering Memorandum to register
the Securities under the 1933 Act or to qualify the Indenture under the Trust
Indenture Act.

     (xvi) The execution, delivery and performance by the Company of the
Purchase Agreement, the Indenture and the Securities and the use of the proceeds
from the sale of the Securities as described in the Offering Memorandum under
the caption "Use of Proceeds" and compliance by the Company with its obligations
under the Purchase Agreement, the Indenture and the Securities do not and will
not result in any violation of any United States federal or New York State
statute or the Delaware General Corporation Law or any rule or regulation issued
pursuant to any New York or United States federal court or governmental agency
or body (other than Blue Sky laws and regulations and laws and regulations
relating to the NASD), except for violations that would not result in a Material
Adverse Effect.

     (xvii) The Company is not an "investment company" or an entity "controlled"
by an "investment company," as such terms are defined in the 1940 Act.

          In addition, we have participated in the preparation of the Offering
Memorandum and in conferences with officers and other representatives of the
Company and representatives and counsel of the Initial Purchasers at which the
contents of the Offering Memorandum and related matters were discussed and,
although we have not undertaken to determine independently, nor do we pass upon
or assume any responsibility, explicitly or implicitly, for the accuracy,
completeness or fairness of the statements contained in the Offering Memorandum,
on the basis of and subject to the foregoing (and relying as to materiality upon
information furnished and assessments made by officers and other representatives
of the Company), no facts have come to our attention to lead us to believe that
the Final Offering Memorandum, as of its date and as of the date of this
opinion, contained an untrue statement of a material fact or omitted or omits to
state a material fact necessary in order to make the statements therein, in the
light of the circumstances under which they were made, not misleading (in each
case, except as to the financial statements and the notes thereto and the
schedules and other financial

                                      A-1-3

<PAGE>

data and statistical data derived from financial data included therein or
omitted therefrom, as to which we express no view).

                                      A-1-4

<PAGE>

                                                                     Exhibit A-2

                       FORM OF OPINION OF GENERAL COUNSEL
                           TO BE DELIVERED PURSUANT TO
                                  SECTION 5(a)

               (i) To the knowledge of such counsel, except as disclosed in the
Offering Memorandum, there is no threatened or pending action, suit, proceeding,
inquiry or investigation, to which the Company or any of its subsidiaries is a
party, or to which the property of the Company or any of its subsidiaries is
subject, before or brought by any court or governmental agency or body applying
Applicable Laws, which would result in a Material Adverse Effect, or which would
materially and adversely affect the consummation of the transactions
contemplated by the Purchase Agreement or the performance by the Company of its
obligations thereunder or under the Securities.

               (ii) To the knowledge of such counsel, neither the Company nor
any of its Designated Subsidiaries is in violation of its charter or by-laws.

               (iii) To the knowledge of such counsel, the execution, delivery
and performance by the Company of the Purchase Agreement, the Indenture and the
Securities and the use of the proceeds from the sale of the Securities as
described in the Offering Memorandum under the caption "Use of Proceeds" and
compliance by the Company with its obligations under the Purchase Agreement, the
Indenture and the Securities do not and will not, whether with or without the
giving of notice or lapse of time or both, conflict with or constitute a breach
of, or default under, any material obligation, agreement, covenant, or condition
contained in any contract, indenture, mortgage, loan agreement, note, lease or
other agreement or instrument that is described or referred to in the Offering
Memorandum or incorporated by reference therein.

               (iv) To the knowledge of such counsel, the execution, delivery
and performance by the Company of the Purchase Agreement, the Indenture and the
Securities and the use of the proceeds from the sale of the Securities as
described in the Offering Memorandum under the caption "Use of Proceeds" and
compliance by the Company with its obligations under the Purchase Agreement, the
Indenture and the Securities will not result in any violation of any Applicable
Law of any Governmental Authority, except for such violations that would not
result in a Material Adverse Effect.

               In rendering such opinions, such counsel may rely, to the extent
such counsel deems necessary, as to factual matters upon certificates or written
statements from officers or other appropriate representatives of the Company and
its subsidiaries and upon certificates of public officials. Such opinions will
be limited to the laws of the State of Texas (and, solely for purposes of the
opinion expressed in paragraph (ii), the Delaware General Corporation Law),
excluding all laws and regulations governing Medicare or any state Medicaid
program, "fraud and abuse" laws and regulations and laws and regulations
regarding illegal remuneration, payments for referrals, false claims or
physician referrals to entities with

                                      A-2-1

<PAGE>

which a physician has a financial or other relationship, or laws and regulations
requiring disclosure of financial interests held by physicians in entities to
which they may refer patients for the provision of health care related goods and
services (collectively, "Applicable Laws"). For the purpose of such opinions,
"Governmental Authority" shall mean any Texas executive, judicial,
administrative or regulatory body applying Applicable Law having jurisdiction
over the Company or any of its subsidiaries.

                                     A-2-2<PAGE>
                                                                     Exhibit 4.3

                                                               Execution Version

================================================================================

                          REGISTRATION RIGHTS AGREEMENT

                          Dated as of November 12, 2003

                                  by and among

                              TRIAD HOSPITALS, INC.

                                       and

               MERRILL LYNCH, PIERCE, FENNER & SMITH INCORPORATED
                                       and
                         BANC OF AMERICA SECURITIES LLC

                  as Representatives of the Initial Purchasers

================================================================================

<PAGE>

                          REGISTRATION RIGHTS AGREEMENT

          THIS REGISTRATION RIGHTS AGREEMENT (the "Agreement") is made and
entered into as of November 12, 2003 by and among TRIAD HOSPITALS, INC., a
Delaware corporation (the "Company") and MERRILL LYNCH, PIERCE, FENNER & SMITH
INCORPORATED and BANC OF AMERICA SECURITIES LLC, as representatives of the
Initial Purchasers listed on Schedule A hereto (collectively, the "Initial
Purchasers").

          This Agreement is made pursuant to the Purchase Agreement dated
November 6, 2003 by and among the Company and the Initial Purchasers (the
"Purchase Agreement"), which provides for, among other things, the sale by the
Company to the Initial Purchasers of an aggregate of $600,000,000 principal
amount of the Company's 7% Senior Subordinated Notes due 2013 (the "Securities")
as described in the Purchase Agreement. In order to induce the Initial
Purchasers to enter into the Purchase Agreement, the Company has agreed to
provide to the Initial Purchasers and their direct and indirect transferees the
registration rights set forth in this Agreement. The execution and delivery of
this Agreement is a condition to the closing under the Purchase Agreement.

          In consideration of the foregoing, the parties hereto agree as
follows:

          1. Definitions. As used in this Agreement, the following capitalized
defined terms shall have the following meanings:

          "Additional Interest" shall have the meaning set forth in Section 2(e)
     hereof.

          "Advice" shall have the meaning set forth in the last paragraph of
     Section 3 hereof.

          "Applicable Period" shall have the meaning set forth in Section 3(r)
     hereof.

          "Business Day" shall mean a day that is not a Saturday, a Sunday, or a
     day on which banking institutions in New York, New York are required to be
     closed.

          "Company" shall have the meaning set forth in the preamble to this
     Agreement and also includes the Company's successors and permitted assigns.

          "Depositary" shall mean The Depository Trust Company or any other
     depositary appointed by the Company; provided, however, that such
     depositary must have an address in the Borough of Manhattan, in the City of
     New York.

          "Effectiveness Period" shall have the meaning set forth in Section
     2(b) hereof.

<PAGE>

                                      -2-

          "Effectiveness Target Date" shall have the meaning set forth in
     Section 2(e) hereof.

          "Event Date" shall have the meaning set forth in Section 2(e) hereof.

          "Exchange Act" shall mean the Securities Exchange Act of 1934, as
     amended.

          "Exchange Offer" shall mean the exchange offer by the Company of
     Exchange Securities for Securities pursuant to Section 2(a) hereof.

          "Exchange Offer Registration" shall mean a registration under the
     Securities Act effected pursuant to Section 2(a) hereof.

          "Exchange Offer Registration Statement" shall mean an exchange offer
     registration statement on an appropriate form under the Securities Act, and
     all amendments and supplements to such registration statement, in each case
     including the Prospectus contained therein, all exhibits thereto and all
     material incorporated by reference therein.

          "Exchange Period" shall have the meaning set forth in Section 2(a)
     hereof.

          "Exchange Securities" shall mean the $600,000,000 7% Senior
     Subordinated Notes due 2013, issued by the Company pursuant to and entitled
     to the benefits of, the Indenture (which shall be qualified under the TIA)
     and registered pursuant to an effective Registration Statement under the
     Securities Act, to be offered to Holders of Securities in exchange for
     Securities pursuant to the Exchange Offer, which shall be identical to such
     Securities (except that (i) interest thereon shall accrue from the last
     date on which interest was paid on such Securities or, if no such interest
     has been paid, from the Issue Date and (ii) the transfer restrictions
     thereon shall be eliminated).

          "Holders" shall mean the Initial Purchasers, for so long as they own
     any Transfer Restricted Securities, each of their direct and indirect
     successors, assigns and transferees who become registered owners of
     Transfer Restricted Securities under the Indenture and each Participating
     Broker-Dealer that holds Exchange Securities for so long as such
     Participating Broker-Dealer is required to deliver a prospectus meeting the
     requirements of the Securities Act in connection with any resale of such
     Exchange Securities.

          "Indenture" shall mean the Indenture relating to the Securities dated
     as of November 12, 2003, among the Company and Citibank N.A., as trustee,
     as the same may be amended from time to time in accordance with the terms
     thereof.

<PAGE>

                                      -3-

          "Initial Purchasers" shall have the meaning set forth in the preamble
     to this Agreement.

          "Inspectors" shall have the meaning set forth in Section 3(m) hereof.

          "Issue Date" shall mean the date on which the Securities are
     originally issued.

          "Majority Holders" shall mean, subject to Section 7(k), the Holders of
     a majority of the aggregate principal amount of outstanding Transfer
     Restricted Securities.

          "Participating Broker-Dealer" shall have the meaning set forth in
     Section 3(r) hereof.

          "Person" shall mean an individual, partnership, corporation, limited
     liability company, trust or unincorporated organization, or a government or
     agency or political subdivision thereof.

          "Private Exchange" shall have the meaning set forth in Section 2(a)
     hereof.

          "Private Exchange Securities" shall have the meaning set forth in
     Section 2(a) hereof.

          "Prospectus" shall mean the prospectus included in a Registration
     Statement, including any preliminary prospectus, and any such prospectus as
     amended or supplemented by any prospectus supplement, including a
     prospectus supplement with respect to the terms of the offering of any
     portion of the Transfer Restricted Securities covered by a Shelf
     Registration Statement, and by all other amendments and supplements to a
     prospectus, including post-effective amendments, and in each case including
     all material incorporated by reference therein.

          "Purchase Agreement" shall have the meaning set forth in the preamble
     to this Agreement.

          "Records" shall have the meaning set forth in Section 3(m) hereof.

          "Registration Expenses" shall mean any and all expenses incident to
     performance of or compliance by the Company with this Agreement, including
     without limitation: (i) all applicable SEC, stock exchange or National
     Association of Securities Dealers, Inc. (the "NASD") registration and
     filing fees, (ii) all fees and expenses incurred in connection with
     compliance with state securities or blue sky laws (including reasonable
     fees and disbursements of one counsel for any Holder that is an Initial
     Purchaser in connection with blue sky qualification of any of the Exchange
     Securities or Transfer Restricted Securities) and compliance with the rules
     of the NASD, (iii) all

<PAGE>

                                      -4-

     applicable expenses incurred by the Company in preparing or assisting in
     preparing, word processing, printing and distributing any Registration
     Statement, any Prospectus and any amendments or supplements thereto, and in
     preparing or assisting in preparing any other documents relating to the
     performance of and compliance with this Agreement, (iv) the reasonable fees
     and disbursements of counsel for the Company and of the independent
     certified public accountants of the Company, including the expenses of any
     "cold comfort" letters required by or incident to such performance or
     compliance with this Agreement, (v) the reasonable fees and expenses of the
     Trustee, and any exchange agent or custodian, (vi) all fees and expenses
     incurred in connection with the listing, if any, of any of the Transfer
     Restricted Securities on any securities exchange or exchanges, if the
     Company, in its discretion, elects to make any such listing, (vii) all
     rating agency fees, if any, and (viii) any reasonable fees and
     disbursements of any underwriter customarily required to be paid by the
     Company or sellers of securities and the fees and expenses of any special
     experts retained by the Company in connection with any Shelf Registration
     Statement; but excluding fees of counsel to the Holders and underwriting
     discounts and commissions and transfer taxes, if any, relating to the sale
     or disposition of Transfer Restricted Securities by a Holder.

          "Registration Statement" shall mean any registration statement
     (including, without limitation, the Exchange Offer Registration Statement
     and the Shelf Registration Statement) of the Company which covers any of
     the Transfer Restricted Securities pursuant to the provisions of this
     Agreement, and all amendments and supplements to any such Registration
     Statement, including post-effective amendments, in each case including the
     Prospectus contained therein, all exhibits thereto and all material
     incorporated by reference therein.

          "SEC" shall mean the Securities and Exchange Commission.

          "Securities" shall have the meaning set forth in the preamble to this
     Agreement.

          "Securities Act" shall mean the Securities Act of 1933, as amended.

          "Shelf Registration" shall mean a registration effected pursuant to
     Section 2(b) hereof.

          "Shelf Registration Event" shall have the meaning set forth in Section
     2(b) hereof.

          "Shelf Registration Statement" shall mean a "shelf" registration
     statement of the Company relating to a "shelf" offering in accordance with
     Rule 415 of the Securities Act, or any similar rule that may be adopted by
     the SEC, pursuant to the provi-

<PAGE>

                                      -5-

     sions of Section 2(b) hereof which covers all of the Transfer Restricted
     Securities, on an appropriate form under the Securities Act, and all
     amendments and supplements to such registration statement, including
     post-effective amendments, in each case including the Prospectus contained
     therein, all exhibits thereto and all material incorporated by reference
     therein.

          "TIA" shall have the meaning set forth in Section 3(k) hereof.

          "Transfer Restricted Securities" shall mean each Security, each
     Exchange Security, if issued, and each Private Exchange Security, if
     issued; provided, however, that each Security, Exchange Security or Private
     Exchange Security, as the case may be, shall cease to be a Transfer
     Restricted Security when (i) with respect to a Security only, such Security
     has been exchanged by a person other than a Participating Broker-Dealer in
     the Exchange Offer for an Exchange Security which is entitled to be resold
     to the public by the Holder thereof without complying with the prospectus
     delivery requirements of the Securities Act, (ii) with respect to a
     Security only, following the exchange by a Participating Broker-Dealer in
     the Exchange Offer of a Security for an Exchange Security, such Exchange
     Security is sold to a purchaser who receives from such Participating
     Broker-Dealer on or prior to the date of such sale a copy of the Prospectus
     contained in the Exchange Offer Registration Statement, as amended or
     supplemented, (iii) such Security or Private Exchange Security, as the case
     may be, has been effectively registered under the Securities Act and
     disposed of in accordance with the Shelf Registration Statement, (iv) such
     Security or Private Exchange Security, as the case may be, is distributed
     to the public pursuant to Rule 144 under the Securities Act (or any similar
     provision then in force, but not Rule 144A under the Securities Act), (v)
     such Security is eligible to be sold pursuant to paragraph (k) of Rule 144,
     (vi) such Security, Exchange Security or Private Exchange Security, as the
     case may be, shall have been otherwise transferred by the holder thereof
     and a new security not bearing a legend restricting further transfer shall
     have been delivered by the Company and subsequent disposition of such new
     security shall not require registration or qualification under the
     Securities Act or any similar state law then in force, or (vii) such
     Security, Exchange Security or Private Exchange Security, as the case may
     be, ceases to be outstanding.

          "Trustee" shall mean the trustee with respect to the Securities under
     the Indenture.

          2. Registration Under the Securities Act.

          (a) Exchange Offer. (i) To the extent not prohibited by any applicable
law or applicable policy of the SEC, the Company shall, for the benefit of the
Holders, at the Company's cost, (A) use their reasonable best efforts to prepare
and, as soon as practicable but not

<PAGE>

                                      -6-

later than 90 days after the Issue Date, file with the SEC an Exchange Offer
Registration Statement on an appropriate form under the Securities Act covering
the offer by the Company to the Holders to exchange all of the Securities for a
like principal amount of Exchange Securities, (B) use their reasonable best
efforts to cause such Exchange Offer Registration Statement to be declared
effective under the Securities Act by the SEC not later than the date which is
210 days after the Issue Date, (C) use their reasonable best efforts to (x) to
include in the Exchange Registration Statement a prospectus for use in any
resales by any Holder of Exchange Securities that is a broker-dealer and (y) to
keep such Registration Statement effective for a period beginning when Exchange
Securities are first issued in the Exchange Offer and ending upon the earlier of
the expiration of the 180th day after the Exchange Offer has been completed or
such time as such broker-dealers no longer own any Transfer Restricted
Securities and (D) use their best efforts to commence the Exchange Offer and, on
or prior to 240 days after the Issue Date, issue Exchange Securities in exchange
for all Securities properly tendered prior thereto in the Exchange Offer. Upon
the effectiveness of the Exchange Offer Registration Statement, the Company
shall promptly, but no later than 5 days after such registration statement has
become effective, commence the Exchange Offer, it being the objective of such
Exchange Offer to enable each Holder eligible and electing to exchange
Securities for Exchange Securities (assuming that such Holder is not an
affiliate of the Company within the meaning of Rule 405 under the Securities Act
or, if it is an affiliate, that it will comply with the registration and
prospectus delivery requirements of the Securities Act to the extent applicable,
and is not a broker-dealer tendering Transfer Restricted Securities acquired
directly from the Company for its own account, acquired the Exchange Securities
in the ordinary course of such Holder's business and has no arrangements or
understandings with any Person to participate in the Exchange Offer for the
purpose of distributing (within the meaning of the Securities Act) the Exchange
Securities) and to transfer such Exchange Securities from and after their
receipt without any limitations or restrictions on transfer under the Securities
Act and under state securities or blue sky laws.

          (ii) In connection with the Exchange Offer, the Company shall:

               (A) mail as promptly as practicable to each Holder a copy of the
          Prospectus forming part of the Exchange Offer Registration Statement,
          together with an appropriate letter of transmittal and related
          documents;

               (B) keep the Exchange Offer open for acceptance for a period of
          not less than 30 days after the date notice thereof is mailed to the
          Holders (or longer if required by applicable law) (such period
          referred to herein as the "Exchange Period");

               (C) utilize the services of the Depositary for the Exchange
          Offer;

<PAGE>

                                      -7-

               (D) permit Holders to withdraw tendered Securities at any time
          prior to 5:00 p.m. (New York time) on the last Business Day of the
          Exchange Period by sending to the institution specified in the notice,
          a telegram, telex, facsimile transmission or letter setting forth the
          name of such Holder, the principal amount of Securities delivered for
          exchange, and a statement that such holder is withdrawing his election
          to have such Securities exchanged;

               (E) notify each Holder that any Securities not tendered will
          remain outstanding and continue to accrue interest but will not retain
          any rights under this Agreement (except in the case of the Initial
          Purchasers and Participating Broker-Dealers as provided herein); and

               (F) otherwise comply in all material respects with all applicable
          laws relating to the Exchange Offer.

          (iii) If, prior to consummation of the Exchange Offer, the Initial
     Purchasers hold any Securities acquired by them and having the status of an
     unsold allotment in the initial distribution, the Company upon the request
     of any Initial Purchaser shall, to the extent not prohibited by any
     applicable law or applicable policy of the SEC, simultaneously with the
     delivery of the Exchange Securities in the Exchange Offer, issue and
     deliver to such Initial Purchaser in exchange (the "Private Exchange") for
     the Securities held by such Initial Purchaser, a like principal amount of
     debt securities of the Company, issued pursuant to, and entitled to the
     benefits of, the Indenture and identical to the Exchange Securities, except
     that such securities shall bear appropriate transfer restrictions (the
     "Private Exchange Securities").

          (iv) The Exchange Securities and the Private Exchange Securities shall
     be issued under (A) the Indenture or (B) an indenture identical in all
     material respects to the Indenture and which, in either case, has been
     qualified under the TIA or is exempt from such qualification and shall
     provide that the Exchange Securities (other than the Private Exchange
     Securities) shall not be subject to the transfer restrictions set forth in
     the Indenture. The Indenture or such indenture shall provide that the
     Exchange Securities, the Private Exchange Securities and the Securities
     shall vote and consent together on all matters as one class and that none
     of the Exchange Securities, the Private Exchange Securities or the
     Securities shall have the right to vote or consent as a separate class on
     any matter. The Private Exchange Securities shall be of the same series as,
     and the Company shall seek to cause the CUSIP Service Bureau to issue the
     same CUSIP numbers for the Private Exchange Securities as for the Exchange
     Securities issued pursuant to the Exchange Offer. The Company shall not
     have any liability hereunder solely as a result of such Private Exchange
     Securities not bearing the same CUSIP number as the Exchange Securities.

<PAGE>

                                      -8-

          (v) The Exchange Offer and the Private Exchange shall not be subject
     to any conditions, other than that (A) in the reasonable opinion of counsel
     to the Company, the Exchange Offer or Private Exchange, as the case may be,
     does not violate applicable law or any applicable policy of the SEC, (B) no
     action or proceeding shall have been instituted or threatened in any court
     or by any governmental agency which might materially impair the ability of
     the Company to proceed with the Exchange Offer or the Private Exchange nor
     shall any material adverse development have occurred in any such action or
     proceeding with respect to the Company, (C) all governmental approvals
     which the Company deems reasonably necessary for the consummation of the
     Exchange Offer or Private Exchange shall have been obtained and (D) the due
     tendering of Transfer Restricted Securities in accordance with the terms of
     the Exchange Offer. As soon as practicable after the close of the Exchange
     Offer and/or the Private Exchange, as the case may be, the Company shall:

               (1) accept for exchange all Securities or portions thereof
          properly tendered and not validly withdrawn pursuant to the Exchange
          Offer or the Private Exchange; and

               (2) deliver, or cause to be delivered, to the Trustee for
          cancellation all Securities or portions thereof so accepted for
          exchange by the Company, and issue, and cause the Trustee under the
          Indenture to promptly authenticate and deliver to each Holder, a new
          Exchange Security or Private Exchange Security, as the case may be,
          equal in principal amount to the principal amount of the Securities
          surrendered by such Holder and accepted for exchange.

          (vi) To the extent not prohibited by any law or applicable policy of
     the SEC, the Company shall use its reasonable best efforts to complete the
     Exchange Offer as provided above, and shall comply with the applicable
     requirements of the Securities Act, the Exchange Act and other applicable
     laws in connection with the Exchange Offer. Each Holder of Securities who
     wishes to exchange such Securities for Exchange Securities in the Exchange
     Offer will be required to make certain customary representations in
     connection therewith, including representations that such Holder is not an
     affiliate of the Company within the meaning of Rule 405 under the
     Securities Act, or if it is an affiliate, that it will comply with the
     registration and prospectus delivery requirements of the Securities Act to
     the extent applicable, that it is not a broker-dealer tendering Transfer
     Restricted Securities acquired directly from the Company for its own
     account, that any Exchange Securities to be received by it will be acquired
     in the ordinary course of business and that at the time of the commencement
     of the Exchange Offer it has no arrangement or understanding with any
     Person to participate in the distribution (within the meaning of the
     Securities Act) of the Exchange Securities. Each Participating
     Broker-Dealer will be required to acknowledge that it will deliver the

<PAGE>

                                      -9-

     Prospectus included in the Exchange Offer Registration Statement in
     connection with the resale of Exchange Securities to the extent it is
     subject to the prospectus delivery requirements of the SEC. The Company
     shall inform the Initial Purchasers of the names and addresses of the
     Holders to whom the Exchange Offer is made, and the Initial Purchasers
     shall have the right to contact such Holders and otherwise facilitate the
     tender of Securities in the Exchange Offer.

          (vii) Upon consummation of the Exchange Offer in accordance with this
     Section 2(a), the provisions of this Agreement shall continue to apply,
     modified as necessary, solely with respect to Transfer Restricted
     Securities that are Private Exchange Securities, Exchange Securities held
     by Participating Broker-Dealers and Transfer Restricted Securities entitled
     to a Shelf Registration pursuant to the first paragraph of Section 2(b)
     hereof.

          (b) Shelf Registration. (i) In the event that (A) the Company is not
permitted to file the Exchange Offer Registration Statement or to consummate the
Exchange Offer because the Exchange Offer is not permitted by applicable law or
SEC policy, (B) the Exchange Offer is not consummated within 240 days after the
Issue Date or (C) any holder of Securities notifies the Company prior to the
20th day following consummation of the Exchange Offer that (1) due to a change
in applicable law or SEC policy it is not entitled to participate in the
Exchange Offer, (2) due to a change in applicable law or SEC policy it may not
resell the Exchange Securities to be acquired by it in the Exchange Offer to the
public without delivering a prospectus and the prospectus contained in the
Exchange Offer Registration Statement is not appropriate or available for such
resales by such holder or (3) it is a broker-dealer and owns Securities acquired
directly from the Company or an affiliate of the Company or (D) the holders of
the Securities may not resell the Exchange Securities to be acquired by them in
the Exchange Offer to the public without restriction under the Securities Act
and without restriction under applicable blue sky or state securities laws (any
of the events specified in (A)-(D) being a "Shelf Registration Event"), then the
Company shall, at its cost, use its reasonable best efforts to file as promptly
as practicable after the date of such Shelf Registration Event and, in any
event, prior to the later of (1) 90 days after the Issue Date or (2) 90 days (or
30 days in the case of clause (B) of this Section 2(b)) after such filing
obligation arises and use its reasonable best efforts to cause the Shelf
Registration Statement to be declared effective by the SEC on or prior to 90
days from such required filing date. No Holder of Transfer Restricted Securities
may include any of its Transfer Restricted Securities in any Shelf Registration
pursuant to this Agreement unless and until such Holder furnishes to the Company
in writing such information as the Company may, after conferring with counsel
with regard to information relating to Holders that would be required by the SEC
to be included in such Shelf Registration Statement or Prospectus included
therein, reasonably request for inclusion in any Shelf Registration Statement or
Prospectus included therein. Each Holder as to which any Shelf Registration is
being effected agrees to furnish to the Company all information with respect to
such Holder

<PAGE>

                                      -10-

necessary to make any information previously furnished to the Company by such
Holder not materially misleading.

          (ii) The Company agrees to use its reasonable best efforts to keep the
     Shelf Registration Statement continuously effective until the second
     anniversary of the effective date of the Shelf Registration Statement
     (subject to extension pursuant to the last paragraph of Section 3 hereof)
     or such earlier time as there are no longer any Transfer Restricted
     Securities outstanding (the "Effectiveness Period"). The foregoing shall
     not apply to actions taken (or contemplated to be taken) by the Company in
     good faith and for valid business reasons involving a material undisclosed
     event (but not including the avoidance of the Company's obligations
     hereunder) (a "Suspension Event"), including, without limitation, the
     acquisition or divestiture of assets or the offering or sale of securities,
     so long as the Company without delay prepares and furnishes to each of the
     Holders of the Transfer Restricted Securities a reasonable number of copies
     of the supplemented or amended prospectus contemplated by Section 3(i)
     hereof, if the Company would be required pursuant to Section 3(e)(E)
     hereof, to notify the Holders of the Transfer Restricted Securities. Any
     such period during which the Company is excused from keeping the Shelf
     Registration Statement effective and usable for offers and sale of the
     Transfer Restricted Securities is referred to as a "Suspension Period";
     provided that, such Suspension Period shall not exceed 45 days in any
     12-month period (whereafter Additional Interest shall accrue and be
     payable); and provided further that the number of days of any actual
     Suspension Period shall be added on to the end of the Effectiveness Period
     specified above. A Suspension Period shall commence on and include the date
     that the Company gives notice that the Shelf Registration Statement is no
     longer effective or the prospectus included therein is no longer usable for
     offers and sales of Transfer Restricted Securities and shall end on the
     earlier to occur of (1) the date on which each seller of Transfer
     Restricted Securities covered by the Shelf Registration Statement either
     receives the copies of the supplemented or amended prospectus contemplated
     by the Section 3(i) hereof or is advised in writing by the Company that the
     use of the prospectus may be resumed and (2) the expiration of 45 days in
     any 12-month period during which one or more Suspension Periods have been
     in effect. The Company further agrees to supplement or make amendments to
     the Shelf Registration Statement, as and when required by the rules,
     regulations or instructions applicable to the registration form used by the
     Company for such Shelf Registration Statement or by the Securities Act or
     rules and regulations thereunder for shelf registration, and the Company
     agrees to furnish to each Holder of Transfer Restricted Securities copies
     of any such supplement or amendment prior to its being used or promptly
     following its filing with the SEC.

          (c) Expenses. The Company shall pay all Registration Expenses in
connection with any registration pursuant to Section 2(a) or 2(b) hereof and the
reasonable fees and ex-

<PAGE>

                                      -11-

penses of one counsel, if any, designated in writing by the Majority Holders to
act as counsel for the Holders of the Transfer Restricted Securities in
connection with a Shelf Registration Statement (which counsel shall be
reasonably satisfactory to the Company). Each Holder shall pay all expenses of
its counsel (other than as set forth above), all underwriting discounts and
commissions and transfer taxes, if any, relating to the sale or disposition of
such Holder's Transfer Restricted Securities pursuant to the Shelf Registration
Statement.

          (d) Effective Registration Statement. An Exchange Offer Registration
Statement pursuant to Section 2(a) hereof or a Shelf Registration Statement
pursuant to Section 2(b) hereof will not be deemed to have become effective
unless it has been declared effective by the SEC; provided, however, that if,
after it has been declared effective, the offering of Transfer Restricted
Securities pursuant to an Exchange Offer Registration Statement or Shelf
Registration Statement is interfered with by any stop order, injunction or other
order or requirement of the SEC or any other governmental agency or court, such
Registration Statement will be deemed not to have been effective during the
period of such interference, until the offering of Transfer Restricted
Securities may legally resume. The Company will be deemed not to have used its
reasonable best efforts to cause the Exchange Offer Registration Statement or
the Shelf Registration Statement, as the case may be, to become, or to remain,
effective during the requisite period if it voluntarily takes any action that
would result in any such Registration Statement not being declared effective or
in the Holders of Transfer Restricted Securities covered thereby not being able
to exchange or offer and sell such Transfer Restricted Securities during that
period, unless such action is required by applicable law or otherwise permitted
by this Agreement.

          (e) Additional Interest. (i) In the event that (A) the applicable
Registration Statement is not filed with the SEC on or prior to the date
specified herein for such filing, (B) the applicable Registration Statement is
not declared effective by the SEC on or prior to the date specified herein for
such effectiveness (the "Effectiveness Target Date"), (C) the Exchange Offer is
required to be consummated hereunder and the Company fails to consummate the
Exchange Offer within 30 business days of the effectiveness date with respect to
the Exchange Offer Registration Statement or (D) the applicable Registration
Statement is filed and declared effective prior to the Effectiveness Target Date
but shall thereafter cease to be effective or usable (other than due to a
Suspension Event) during the periods specified herein without being immediately
succeeded by an additional Registration Statement covering the Transfer
Restricted Securities which has been filed and declared effective (each such
event referred to in clauses (A) through (D), a "Registration Default"), then
the Company shall pay, jointly and severally, liquidated damages to each Holder
of Transfer Restricted Securities as to which such Registration Default relates
("Additional Interest"), with respect to the first 90-day period (or portion
thereof) while a Registration Default or Defaults is continuing immediately
following the occurrence of such Registration Default, in an amount equal to
0.25% per annum of the principal amount of the Securities. The amount of
Additional Interest will in-

<PAGE>

                                      -12-

crease by an additional 0.25% per annum of the principal amount of the
Securities for each subsequent 90-day period (or portion thereof) while a
Registration Default or Defaults is continuing until all Registration Defaults
have been cured, up to an aggregate maximum amount of 1.00% per annum of the
principal amount of the Securities. Additional Interest shall be computed based
on the actual number of days elapsed during which any such Registration Default
or Defaults exist. Following the cure of a Registration Default, the accrual of
Additional Interest with respect to such Registration Default will cease.
Additional Interest pursuant to this Section 2(e) shall be the exclusive
monetary remedy available to the Holders of the Securities in respect of any
Registration Default. Additional Interest will not accrue and be payable as set
forth above during any Suspension Period to the extent such Suspension Period
does not exceed 45 days in any 12-month period.

          (ii) The Company shall notify the Trustee within five Business Days
     after each and every date on which an event occurs in respect of which
     Additional Interest is required to be paid (an "Event Date"). All accrued
     Additional Interest shall be paid to the holders entitled thereto, in the
     manner provided for the payment of interest in the Indenture and the
     Securities, on each interest payment date, as more fully set forth in the
     Indenture and the Securities. The amount of Additional Interest will be
     determined by multiplying the applicable additional interest rate by the
     principal amount of the Securities, as the case may be, multiplied by a
     fraction, the numerator of which is the number of days such additional
     interest rate was applicable during such period (determined on the basis of
     a 360-day year comprised of twelve 30-day months), and the denominator of
     which is 360.

          (f) Specific Enforcement. Without limiting the remedies available to
the Initial Purchasers and the Holders, the Company acknowledges that any
failure by the Company to comply with its obligations under Section 2(a) and
Section 2(b) hereof may result in material irreparable injury to the Initial
Purchasers or the Holders for which there is no adequate remedy at law, that it
would not be possible to measure damages for such injuries precisely and that,
in the event of any such failure, the Initial Purchasers or any Holder may
obtain such relief as may be required to specifically enforce the Company's
obligations under Section 2(a) and Section 2(b) hereof.

          3. Registration Procedures. In connection with the obligations of the
Company with respect to the Registration Statements pursuant to Sections 2(a)
and 2(b) hereof, the Company shall:

          (a) prepare and file with the SEC a Registration Statement or
     Registration Statements as prescribed by Sections 2(a) and 2(b) hereof
     within the relevant time period specified in Section 2 hereof on the
     appropriate form under the Securities Act, which form (i) shall be selected
     by the Company, (ii) shall, in the case of a Shelf Reg-

<PAGE>

                                      -13-

     istration, be available for the sale of the Transfer Restricted Securities
     by the selling Holders thereof and (iii) shall comply as to form in all
     material respects with the requirements of the applicable form and include
     all financial statements required by the SEC to be filed therewith; and use
     its reasonable best efforts to cause such Registration Statement to become
     effective and remain effective in accordance with Section 2 hereof. The
     Company shall not file any Shelf Registration Statement or related
     Prospectus or any amendments or supplements thereto in respect of which the
     Holders must provide information for inclusion therein without the Holders
     or their counsel being afforded an opportunity to review such documentation
     a reasonable time prior to the filing of such document or, with respect to
     such information relating to such Holders, if the Majority Holders or such
     Participating Broker-Dealer, as the case may be, their counsel or the
     managing underwriters, if any, shall reasonably object;

          (b) prepare and file with the SEC such amendments and post-effective
     amendments to each Registration Statement as may be necessary under
     applicable law to keep such Registration Statement effective for the
     Effectiveness Period or the Applicable Period, as the case may be; and
     cause each Prospectus to be supplemented by any required prospectus
     supplement and as so supplemented to be filed pursuant to Rule 424 (or any
     similar provision then in force) under the Securities Act, and comply in
     all material respects with the provisions of the Securities Act, the
     Exchange Act and the rules and regulations promulgated thereunder
     applicable to it with respect to the disposition of all securities covered
     by each Registration Statement during the Effectiveness Period or the
     Applicable Period, as the case may be, in accordance with the intended
     method or methods of distribution by the selling Holders thereof described
     in this Agreement (including sales by any Participating Broker-Dealer);

          (c) in the case of a Shelf Registration, (i) notify each Holder of
     Transfer Restricted Securities, at least three Business Days prior to
     filing, that a Shelf Registration Statement with respect to the Transfer
     Restricted Securities is being filed and advising such Holder that the
     distribution of Transfer Restricted Securities will be made in accordance
     with the method selected by the Majority Holders participating in the Shelf
     Registration; (ii) furnish to each Holder of Transfer Restricted
     Securities, without charge, as many copies of each Prospectus, and any
     amendment or supplement thereto and such other documents as such Holder may
     reasonably request, in order to facilitate the disposition of the Transfer
     Restricted Securities; and (iii) subject to Section 2(b)(ii) hereof and the
     last paragraph of Section 3 hereof, hereby consent to the use of the
     Prospectus or any amendment or supplement thereto by each of the selling
     Holders of Transfer Restricted Securities in connection with the offering
     and sale of the Transfer Restricted Securities covered by such Prospectus
     or any amendment or supplement thereto;

<PAGE>

                                      -14-

          (d) in the case of a Shelf Registration, use its reasonable best
     efforts to register or qualify, as may be required by applicable law, the
     Transfer Restricted Securities under all applicable state securities or
     "blue sky" laws of such jurisdictions by the time the applicable
     Registration Statement is declared effective by the SEC as any Holder of
     Transfer Restricted Securities covered by a Registration Statement shall
     reasonably request in advance of such date of effectiveness, and do any and
     all other acts and things which may be reasonably necessary or advisable to
     enable such Holder to consummate the disposition in each such jurisdiction
     of such Transfer Restricted Securities owned by such Holder;

          (e) in the case of (i) a Shelf Registration or (ii) Participating
     Broker-Dealers who have notified the Company that they will be utilizing
     the Prospectus contained in the Exchange Offer Registration Statement as
     provided in Section 3(r) hereof, notify each Holder of Transfer Restricted
     Securities, or such Participating Broker-Dealers, as the case may be, their
     counsel, if any, promptly and confirm such notice in writing (if such
     notice was not originally given in writing) (A) when a Registration
     Statement has become effective and when any post-effective amendments and
     supplements thereto become effective, (B) of any request by the SEC or any
     state securities authority for amendments and supplements to a Registration
     Statement or Prospectus or for additional information after the
     Registration Statement has become effective, (C) of the issuance by the SEC
     or any state securities authority of any stop order suspending the
     effectiveness of a Registration Statement or the initiation of any
     proceedings for that purpose, (D) if the Company receives any notification
     with respect to the suspension of the qualification of the Transfer
     Restricted Securities to be sold by any Participating Broker-Dealer for
     offer or sale in any jurisdiction or the initiation of any proceeding for
     such purpose, (E) of the happening of any event or the failure of any event
     to occur or the discovery of any facts or otherwise during the
     Effectiveness Period or the Applicable Period, as the case may be, which
     makes any statement made in such Registration Statement or Prospectus
     untrue in any material respect or which causes such Registration Statement
     or Prospectus to omit to state a material fact necessary to make the
     statements therein, in the light of the circumstances under which they were
     made, not misleading and (F) the Company's determination that a
     post-effective amendment to the Registration Statement would be
     appropriate;

          (f) use its reasonable best efforts to obtain the withdrawal of any
     order suspending the effectiveness of a Registration Statement as soon as
     practicable;

          (g) in the case of a Shelf Registration, furnish to each Holder of
     Transfer Restricted Securities who so requests, without charge, at least
     one conformed copy of each Registration Statement relating to such Shelf
     Registration and any post-effective

<PAGE>

                                      -15-

     amendment thereto (without documents incorporated therein by reference or
     exhibits thereto, unless requested);

          (h) in the case of a Shelf Registration, unless any Transfer
     Restricted Securities shall be in book-entry only form, cooperate with the
     selling Holders of Transfer Restricted Securities to facilitate the timely
     preparation and delivery of certificates not bearing any restrictive
     legends representing Securities covered by such Shelf Registration to be
     sold and relating to the subsequent transfer of such Securities; and cause
     such Securities to be in such denominations (consistent with the provisions
     of the Indenture) and registered in such names as the selling Holders may
     reasonably request at least three Business Days prior to the closing of any
     sale of Transfer Restricted Securities;

          (i) in the case of (i) a Shelf Registration or (ii) Participating
     Broker-Dealers who have notified the Company that they will be utilizing
     the Prospectus contained in the Exchange Offer Registration Statement as
     provided in Section 3(r), upon the occurrence of any circumstance
     contemplated by Section 3(e)(B), 3(e)(C), 3(e)(D), 3(e)(E) or 3(e)(F)
     hereof, prepare a supplement or post-effective amendment to a Registration
     Statement or the related Prospectus or any document incorporated therein by
     reference or file any other required document so that (subject to Section
     3(a)), as thereafter delivered to the purchasers of the Transfer Restricted
     Securities, such Prospectus will not contain any untrue statement of a
     material fact or omit to state a material fact necessary to make the
     statements therein, in the light of the circumstances under which they were
     made, not misleading; and to notify each Holder or Participating
     Broker-Dealer, as applicable, to suspend use of the Prospectus as promptly
     as practicable after the occurrence of such an event;

          (j) obtain a CUSIP number for all Exchange Securities or Private
     Exchange Securities or Securities, as the case may be, not later than the
     effective date of a Registration Statement, and provide the Trustee with
     printed certificates for the Exchange Securities or the Private Exchange
     Securities, as the case may be, in a form eligible for deposit with the
     Depositary;

          (k) (i) cause the Indenture or the indenture provided in Section 2(a)
     to be qualified under the Trust Indenture Act of 1939, as amended (the
     "TIA"), in connection with the registration of the Transfer Restricted
     Securities, (ii) cooperate with the Trustee or any trustee under such
     indenture and the Holders to effect such changes to the Indenture or such
     indenture as may be required for the Indenture or such indenture to be so
     qualified in accordance with the terms of the TIA and (iii) execute, and
     use reasonable best efforts to cause the Trustee or any trustee under such
     indenture to execute, all documents as may be required to effect such
     changes, and all other forms and

<PAGE>

                                      -16-

     documents required to be filed with the SEC to enable the Indenture or such
     indenture to be so qualified in a timely manner;

          (l) in the case of a Shelf Registration, enter into agreements
     (including underwriting agreements) and take all such other customary and
     appropriate actions as are reasonably requested by the Majority Holders in
     order to expedite or facilitate the disposition of such Transfer Restricted
     Securities, and in such connection, whether or not an underwriting
     agreement is entered into and whether or not the registration is an
     underwritten registration, (i) make such representations and warranties to
     Holders of such Transfer Restricted Securities and the underwriters (if
     any) with respect to the business of the Company and its subsidiaries as
     then conducted and the Registration Statement, Prospectus and documents, if
     any, incorporated or deemed to be incorporated by reference therein, in
     each case, as are customarily made by issuers in connection with an
     offering of debt securities as contemplated hereby pursuant to any
     appropriate agreement or to a registration statement filed on the form
     applicable to the Shelf Registration, and confirm the same if and when
     requested by the Majority Holders; (ii) obtain opinions of counsel to the
     Company in form and substance reasonably satisfactory to the managing
     underwriters (if any) and the Holders of at least 35% in aggregate
     principal amount of the Transfer Restricted Securities covered by such
     Registration Statement, addressed to each selling Holder and the managing
     underwriters covering the matters customarily covered in opinions requested
     in connection with an offering of debt securities as contemplated hereby
     pursuant to any appropriate agreement or to a registration statement filed
     on the form applicable to the Shelf Registration; (iii) obtain "cold
     comfort" letters and updates thereof from the independent certified public
     accountants of the Company (and, if necessary, any other independent
     certified public accountants of any subsidiary of the Company or of any
     business acquired by the Company for which financial statements and
     financial data are, or are required to be, included in the Registration
     Statement), addressed to the Company and the underwriters (if any) with
     copies to each of the selling Holders of Transfer Restricted Securities,
     such letters to be in customary form and covering matters of the type
     customarily covered in "cold comfort" letters in connection with an
     offering of debt securities as contemplated hereby pursuant to any
     appropriate agreement or to a registration statement filed on the form
     applicable to the Shelf Registration; and (iv) if an underwriting agreement
     is entered into, the same shall contain indemnification provisions and
     procedures substantially equivalent to those set forth in Section 4 hereof
     (or such other provisions and procedures acceptable to the Company and the
     Holders of a majority in aggregate principal amount of Transfer Restricted
     Securities covered by such Registration Statement and the managing
     underwriters) with respect to all parties to be indemnified pursuant to
     said Section (including, without limitation, such selling Holders and such
     underwriters). The above shall be done at each closing in respect of the
     sale of Transfer Restricted Securities, or as and to the extent required
     thereunder;

<PAGE>

                                      -17-

          (m) if (i) a Shelf Registration is filed pursuant to Section 2(b) or
     (ii) a Prospectus contained in an Exchange Offer Registration Statement
     filed pursuant to Section 2(a) is required to be delivered under the
     Securities Act by any Participating Broker-Dealer who seeks to sell
     Exchange Securities during the Applicable Period, make available for
     inspection by each selling Holder of Transfer Restricted Securities and
     each such person who would be an "underwriter" as a result of either (A)
     the sale by such person of Securities covered by such Shelf Registration
     Statement or (B) the sale during the Applicable Period by a Participating
     Broker-Dealer of Exchange Securities (provided that a Participating
     Broker-Dealer shall not be deemed to be an underwriter solely as a result
     of it being required to deliver a prospectus in connection with any resale
     of Exchange Securities) and any attorney, accountant or other agent
     retained by any such person (collectively, the "Inspectors"), at the
     offices where normally kept, during reasonable business hours and upon
     reasonable prior notice, all financial and other records, pertinent
     corporate documents and properties of the Company and its subsidiaries
     (collectively, the "Records") as shall be reasonably necessary to enable
     them to exercise any applicable due diligence responsibilities, and cause
     the officers, directors and employees of the Company and its subsidiaries
     to supply all information in each case reasonably requested by any such
     Inspector in connection with such Registration Statement. Records which the
     Company determines, in good faith, to be confidential and any Records which
     they notify the Inspectors are confidential shall not be disclosed by the
     Inspectors to any other Person unless (1) the disclosure of such Records is
     necessary to avoid or correct a material misstatement or omission in such
     Registration Statement, (2) the disclosure is necessary in connection with
     any action, suit or proceeding, (3) the release of such Records is ordered
     pursuant to a subpoena or other order from a court of competent
     jurisdiction or (4) the information in such Records has been made generally
     available to the public. Each such Holder and each such Participating
     Broker-Dealer will be required to agree in writing that information
     obtained by it as a result of such inspections shall be deemed confidential
     and shall not be used by it as the basis for any market transactions in the
     securities of the Company unless and until such is made generally available
     to the public. Each selling Holder of such Transfer Restricted Securities
     and each such Participating Broker-Dealer will be required to further agree
     in writing that it will, upon learning that disclosure of such Records is
     sought under (1) or (2) above, give notice to the Company and allow the
     Company and its subsidiaries at their own expense to undertake appropriate
     action to prevent disclosure of the Records deemed confidential; provided
     that the foregoing inspection and information gathering shall be
     coordinated by one counsel designated by and on behalf of the parties
     referenced in clauses (A) and (B) of this Section 3(m);

          (n) comply with all applicable rules and regulations of the SEC so
     long as the provisions of this Agreement are applicable and make generally
     available to its security holders earnings statements satisfying the
     provisions of Section 11(a) of the Se-

<PAGE>

                                      -18-

     curities Act and Rule 158 thereunder (or any similar rule promulgated under
     the Securities Act) no later than 45 days after the end of any 12-month
     period (or 90 days after the end of any 12-month period if such period is a
     fiscal year) (i) commencing at the end of any fiscal quarter in which
     Transfer Restricted Securities are sold to underwriters in a firm
     commitment or best efforts underwritten offering and (ii) if not sold to
     underwriters in such an offering, commencing on the first day of the first
     fiscal quarter of the Company after the effective date of a Registration
     Statement, which statements shall cover said 12-month periods;

          (o) if an Exchange Offer or a Private Exchange is to be consummated,
     upon proper delivery of Securities by Holders to the Company (or to such
     other Person as directed by the Company) in exchange for the Exchange
     Securities or the Private Exchange Securities, as the case may be, the
     Company shall mark, or cause to be marked, on such Securities and on the
     books of the Trustee, the Note Registrar (as defined in the Indenture) and,
     if necessary, the Depositary, delivered by such Holders that such
     Securities are being canceled in exchange for the Exchange Securities or
     the Private Exchange Securities, as the case may be; but in no event shall
     such Securities be marked as paid or otherwise satisfied solely as a result
     of being exchanged for Exchange Securities or Private Exchange Securities
     in the Exchange Offer or the Private Exchange, as the case may be;

          (p) cooperate with each seller of Transfer Restricted Securities
     covered by any Registration Statement participating in the disposition of
     such Transfer Restricted Securities and one counsel acting on behalf of all
     such sellers in connection with the filings, if any, required to be made
     with the NASD;

          (q) use its reasonable best efforts to take all other steps necessary
     to effect the registration of the Transfer Restricted Securities covered by
     a Registration Statement contemplated hereby; and

          (r) in the case of the Exchange Offer Registration Statement (A)
     include in the Exchange Offer Registration Statement a section entitled
     "Plan of Distribution," which section shall be reasonably acceptable to the
     Initial Purchasers, and which shall contain a summary statement of the
     positions taken or policies made by the staff of the SEC with respect to
     the potential "underwriter" status of any broker-dealer ("Participating
     Broker-Dealer") that holds Transfer Restricted Securities acquired for its
     own account as a result of market-making activities or other trading
     activities and that will be the beneficial owner (as defined in Rule 13d-3
     under the Exchange Act) of Exchange Securities to be received by such
     broker-dealer in the Exchange Offer, whether such positions or policies
     have been publicly disseminated by the staff of the SEC or such positions
     or policies, in the reasonable judgment of the Initial Purchasers,
     repre-

<PAGE>

                                      -19-

     sent the prevailing views of the staff of the SEC, including a statement
     that any such Participating Broker-Dealer who receives Exchange Securities
     for Transfer Restricted Securities pursuant to the Exchange Offer may be
     deemed a statutory underwriter and must deliver a prospectus meeting the
     requirements of the Securities Act in connection with any resale of such
     Exchange Securities, (B) furnish to each Participating Broker-Dealer who
     has delivered to the Company the notice referred to in Section 3(e),
     without charge, as many copies of each Prospectus included in the Exchange
     Offer Registration Statement, including any preliminary prospectus, and any
     amendment or supplement thereto, as such Participating Broker-Dealer may
     reasonably request, (C) subject to the provisions of this Agreement, hereby
     consent to the use of the Prospectus forming part of the Exchange Offer
     Registration Statement or any amendment or supplement thereto, by any
     Person subject to the prospectus delivery requirements of the SEC,
     including all Participating Broker-Dealers, in connection with the sale or
     transfer of the Exchange Securities covered by the Prospectus or any
     amendment or supplement thereto, (D) use its reasonable best efforts to
     keep the Exchange Offer Registration Statement effective and use its
     reasonable best efforts to amend and supplement the Prospectus contained
     therein in order to permit such Prospectus to be lawfully delivered by all
     Persons subject to the prospectus delivery requirements of the Securities
     Act for such period of time as such Persons must comply with such
     requirements in order to resell the Exchange Securities; provided, however,
     that such period shall not be required to exceed 180 days (or such longer
     period if extended pursuant to the last sentence of Section 3 hereof) (the
     "Applicable Period"), and (E) include in the transmittal letter or similar
     documentation to be executed by an exchange offeree in order to participate
     in the Exchange Offer (1) the following provision:

          "If the exchange offeree is a broker-dealer holding Securities
          acquired for its own account as a result of market-making activities
          or other trading activities, it will deliver a prospectus meeting the
          requirements of the Securities Act in connection with any resale of
          Exchange Securities received in respect of such Securities pursuant to
          the Exchange Offer";

     and (2) a statement to the effect that by a broker-dealer making the
     acknowledgment described in clause (1) and by delivering a Prospectus in
     connection with the exchange of Transfer Restricted Securities, such
     broker-dealer will not be deemed to admit that it is an underwriter within
     the meaning of the Securities Act.

          The Company may require each seller of Transfer Restricted Securities
as to which any registration is being effected to furnish to the Company such
information regarding such seller and the proposed distribution of such Transfer
Restricted Securities as the Company may from time to time reasonably request in
writing. The Company may exclude from such registration the Transfer Restricted
Securities of any seller who fails to furnish such in-

<PAGE>

                                      -20-

formation within a reasonable time (at least 21 calendar days from the date on
which such request is mailed) and shall be under no obligation to compensate any
such seller for any lost income, interest or other opportunity forgone, or any
liability incurred, as a result of the Company's decision to exclude such
seller.

          In the case of (i) a Shelf Registration Statement or (ii)
Participating Broker-Dealers who have notified the Company that they will be
utilizing the Prospectus contained in the Exchange Offer Registration Statement
as provided in Section 3(r) hereof that are seeking to sell Exchange Securities
and are required to deliver Prospectuses, each Holder agrees that, upon receipt
of any notice from the Company of the happening of any event of the kind
described in Section 3(e)(B), 3(e)(C), 3(e)(D), 3(e)(E) or 3(e)(F) hereof, such
Holder or Participating Broker-Dealer, as the case may be, will forthwith
discontinue disposition of Transfer Restricted Securities or Exchange
Securities, as the case may be, pursuant to a Registration Statement until such
Holder's or Participating Broker-Dealer's, as the case may be, receipt of the
copies of the supplemented or amended Prospectus contemplated by Section 3(i)
hereof or until it is advised in writing (the "Advice") by the Company that the
use of the applicable Prospectus may be resumed, and, if so directed by the
Company, such Holder will deliver to the Company (at the Company's expense) all
copies in such Holder's or Participating Broker-Dealer's, as the case may be,
possession, other than permanent file copies then in such Holder's or
Participating Broker-Dealer's, as the case may be, possession, of the Prospectus
covering such Transfer Restricted Securities or Exchange Securities, as the case
may be, current at the time of receipt of such notice. If the Company shall give
any such notice to suspend the disposition of Transfer Restricted Securities or
Exchange Securities, as the case may be, pursuant to a Registration Statement,
the Company shall use its reasonable best efforts to file and have declared
effective (if an amendment) as soon as practicable an amendment or supplement to
the Registration Statement and, in the case of an amendment, have such amendment
declared effective as soon as practicable and shall extend the period during
which such Registration Statement shall be maintained effective pursuant to this
Agreement by the number of days in the period from and including the date of the
giving of such notice to and including the date when the Company shall have made
available to the Holders or Participating Broker-Dealers, as the case may be,
(A) copies of the supplemented or amended Prospectus necessary to resume such
dispositions or (B) the Advice.

          4. Indemnification and Contribution. (a) The Company shall indemnify
and hold harmless the Initial Purchasers, each Holder of Transfer Restricted
Securities in the Registration Statement, each Participating Broker-Dealer, each
underwriter who participates in an offering of Transfer Restricted Securities,
their respective affiliates, and each Person, if any, who controls any of such
parties within the meaning of Section 15 of the Securities Act or Section 20 of
the Exchange Act, as follows:

<PAGE>

                                      -21-

          (i) against any and all loss, liability, claim, damage and expense
     whatsoever, joint or several, as incurred, arising out of any untrue
     statement or alleged untrue statement of a material fact contained in any
     Registration Statement (or any amendment or supplement thereto), covering
     Transfer Restricted Securities or Exchange Securities, including all
     documents incorporated therein by reference, or the omission or alleged
     omission therefrom of a material fact required to be stated therein or
     necessary to make the statements therein not misleading or arising out of
     any untrue statement or alleged untrue statement of a material fact
     contained in any Prospectus (or any amendment or supplement thereto) or the
     omission or alleged omission therefrom of a material fact necessary in
     order to make the statements therein, in the light of the circumstances
     under which they were made, not misleading;

          (ii) against any and all loss, liability, claim, damage and expense
     whatsoever, joint or several, as incurred, to the extent of the aggregate
     amount paid in settlement of any litigation, or any investigation or
     proceeding by any governmental agency or body, commenced or threatened, or
     of any claim whatsoever based upon any such untrue statement or omission,
     or any such alleged untrue statement or omission; provided that (subject to
     Section 4(d) below) any such settlement is effected with the prior written
     consent of the Company; and

          (iii) against any and all expenses whatsoever, as incurred (including
     reasonable fees and disbursements of one counsel (in addition to any local
     counsel) chosen as provided in Section 4(c) below) reasonably incurred in
     investigating, preparing or defending against any litigation, or any
     investigation or proceeding by any court or governmental agency or body,
     commenced or threatened, or any claim whatsoever based upon any such untrue
     statement or omission, or any such alleged untrue statement or omission, to
     the extent that any such expense is not paid under subparagraph (i) or (ii)
     of this Section 4(a);

provided, however, that this indemnity does not apply to any loss, liability,
claim, damage or expense to the extent arising out of an untrue statement or
omission or alleged untrue statement or omission made in reliance upon and in
conformity with written information furnished to the Company by or on behalf of
the Initial Purchasers, such Holder, such Participating Broker-Dealer or any
underwriter with respect to such Initial Purchasers, Holder, Participating
Broker-Dealer or underwriter, as the case may be, expressly for use in the
Registration Statement (or any amendment or supplement thereto) or any
Prospectus (or any amendment or supplement thereto); provided, further, that the
foregoing indemnity with respect to a preliminary prospectus in any Shelf
Registration Statement shall not inure to the benefit of any person or entity
(or to the benefit of any person controlling such person or entity) from whom
the person asserting any such losses, claims, damages or liabilities purchased
Transfer Restricted Securities if (i) such untrue statement or omission or
alleged untrue statement or omission made in

<PAGE>

                                      -22-

such preliminary prospectus was eliminated or remedied in the final Prospectus
(as amended or supplemented if the Company shall have furnished any amendments
or supplements thereto to such Holder prior to confirmation for the sale of such
Transfer Restricted Securities to such person by such Holder) and (ii) a copy of
the final Prospectus (as so amended and supplemented) was not furnished to such
person at or prior to the written confirmation of the sale of such Transfer
Restricted Securities to such person, unless such failure to deliver was a
result of non-compliance by the Company with Section 3(c).

          (b) Each Holder agrees, severally and not jointly, to indemnify and
hold harmless the Company, the Initial Purchasers and the other selling Holders
and each of their respective officers and directors and each Person, if any, who
controls the Company, the Initial Purchasers, any underwriter or any other
selling Holder within the meaning of Section 15 of the Act or Section 20 of the
Exchange Act, against any and all loss, liability, claim, damage and expense
whatsoever described in the indemnity contained in Section 4(a) hereof, as
incurred, but only with respect to untrue statements or omissions, or alleged
untrue statements or omissions, made in the Registration Statement (or any
amendment or supplement thereto) or any Prospectus (or any amendment or
supplement thereto) in reliance upon and in conformity with written information
furnished to the Company by or on behalf of such selling Holder with respect to
such Holder expressly for use in the Registration Statement (or any supplement
thereto), or any such Prospectus (or any amendment thereto); provided, however,
that, in the case of the Shelf Registration Statement, no such Holder shall be
liable for any claims hereunder in excess of the amount of net proceeds received
by such Holder from the sale of Transfer Restricted Securities pursuant to the
Shelf Registration Statement.

          (c) Each indemnified party shall give notice as promptly as reasonably
practicable to each indemnifying party of any action commenced against it in
respect of which indemnity may be sought hereunder, but failure to so notify an
indemnifying party shall not relieve such indemnifying party from any liability
hereunder to the extent it is not materially prejudiced as a result thereof and
in any event shall not relieve it from any liability which it may have otherwise
than on account of this indemnity agreement. In the case of parties indemnified
pursuant to Section 4(a) above, counsel to all the indemnified parties shall be
selected by the Initial Purchasers, and, in the case of parties indemnified
pursuant to Section 4(b) above, counsel to all the indemnified parties shall be
selected by the Company. An indemnifying party may participate at its own
expense in the defense of any such action and, to the extent that the
indemnifying party may wish, assume the defense of any such action, with counsel
reasonably satisfactory to the indemnified party, and after notice from the
indemnifying party to the indemnified party of its election to assume the
defense of such action, the indemnifying party will not be liable to such
indemnified party under this Section 4 for any legal or other expenses
subsequently incurred by the indemnified party in connection with the defense of
such action other than reasonable costs of investigation; provided, however,
that counsel to the indemnifying party shall not (except with the consent of the
indemnified

<PAGE>

                                      -23-

party) also be counsel to the indemnified party. In no event shall the
indemnifying parties be liable for fees and expenses of more than one counsel
(in addition to any local counsel) separate from their own counsel for all
indemnified parties in connection with any one action or separate but similar or
related actions arising out of the same general allegations or circumstances. No
indemnifying party shall, without the prior written consent of the indemnified
parties, settle or compromise or consent to the entry of any judgment with
respect to any litigation, or any investigation or proceeding by any
governmental agency or body, commenced or threatened, or any claim whatsoever in
respect of which indemnification or contribution is or could be sought under
this Section 4 (whether or not the indemnified parties are actual or potential
parties thereto), unless such settlement, compromise or consent (i) includes a
full and unconditional release of each indemnified party from all liability
arising out of such litigation, investigation, proceeding or claim and (ii) does
not include a statement as to or an admission of fault, culpability or a failure
to act by or on behalf of any indemnified party. No indemnified party shall,
without the prior written consent of the indemnifying party (which consent shall
not be unreasonably withheld), settle or compromise or consent to the entry of
judgment with respect to any litigation, or any investigation or proceeding by
any governmental agency or body, commenced or threatened, or any claim
whatsoever in respect of which indemnification or contribution could be sought
under this Section 4.

          (d) If at any time an indemnified party shall have requested an
indemnifying party to reimburse the indemnified party for reasonable fees and
expenses of counsel in accordance with Section 4(a)(iii), then such indemnifying
party agrees that it shall be liable for any settlement of the nature
contemplated by Section 4(a)(ii) effected without its written consent if (i)
such settlement is entered into more than 60 days after receipt by such
indemnifying party of the aforesaid request, (ii) such indemnifying party shall
have received notice of the terms of such settlement at least 45 days prior to
such settlement being entered into and (iii) such indemnifying party shall not
have reimbursed such indemnified party in accordance with such request prior to
the date of such settlement.

          (e) (i) In order to provide for just and equitable contribution in
circumstances under which any of the indemnity provisions set forth in this
Section 4 is for any reason held to be unavailable to the indemnified parties
although applicable in accordance with its terms, the Company and the Holders,
as applicable, shall contribute to the aggregate losses, liabilities, claims,
damages and expenses of the nature contemplated by such indemnity agreement
incurred by the Company and the Holders; provided, however, that no Person
guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of
the Securities Act) shall be entitled to contribution from any Person that was
not guilty of such fraudulent misrepresentation. As between the Company and the
Holders, such parties shall contribute to such aggregate losses, liabilities,
claims, damages and expenses of the nature contemplated by such indemnity
agreement in such proportion as shall be appropriate to reflect the relative
fault of the Company, on the one hand, and the Holders of Transfer Restricted
Securities, the Participating

<PAGE>

                                      -24-

Broker-Dealer or Initial Purchasers, as the case may be, on the other hand, in
connection with the statements or omissions which resulted in such losses,
liabilities, claims, damages or expenses, as well as any other relevant
equitable considerations.

          (ii) The relative fault of the Company, on the one hand, and the
     Holders of Transfer Restricted Securities, the Participating Broker-Dealer
     or the Initial Purchasers, as the case may be, on the other hand, shall be
     determined by reference to, among other things, whether the untrue or
     alleged untrue statement of a material fact or the omission or alleged
     omission to state a material fact relates to information supplied by the
     Company, or by the Holder of Transfer Restricted Securities, the
     Participating Broker-Dealer or the Initial Purchasers, as the case may be,
     and the parties' relative intent, knowledge, access to information and
     opportunity to correct or prevent such statement or omission.

          (iii) Notwithstanding the provisions of this Section 4, no Holder
     shall be required to contribute any amount in excess of the amount by which
     the total price at which the Securities sold by it under the Shelf
     Registration Statement exceeds the amount of any damages which such Holder
     has otherwise been required to pay by reason of such untrue or alleged
     untrue statement or omission or alleged omission.

          (iv) The Company and the Holders of the Transfer Restricted Securities
     and the Initial Purchasers agree that it would not be just and equitable if
     contribution pursuant to this Section 4 were determined by pro rata
     allocation or by any other method of allocation which does not take account
     of the equitable considerations referred to above in this Section 4.

          (v) For purposes of this Section 4, each affiliate of any Person, if
     any, who controls a Holder of Transfer Restricted Securities, the Initial
     Purchasers or a Participating Broker-Dealer within the meaning of Section
     15 of the Securities Act or Section 20 of the Exchange Act shall have the
     same rights to contribution as such other Person, and each director of the
     Company (including any person who, with his consent, is named in any
     Registration Statement as about to become a director of the Company) each
     affiliate of the Company, each executive officer of the Company who signed
     the Registration Statement, and each Person, if any, who controls the
     Company within the meaning of Section 15 of the Securities Act or Section
     20 of the Exchange Act shall have the same rights to contribution as the
     Company.

          5. Participation in Underwritten Registrations. No Holder may
participate in any underwritten registration hereunder unless such Holder (i)
agrees to sell such Holder's Transfer Restricted Securities on the basis
provided in any underwriting arrangements approved by the Persons entitled
hereunder to approve such arrangements and (ii) completes and executes all
reasonable questionnaires, powers of attorney, indemnities, underwriting
agree-

<PAGE>

                                      -25-

ments and other documents reasonably required under the terms of such
underwriting arrangements. The Company shall be under no obligation to
compensate any Holder for lost income, interest or other opportunity foregone,
or other liability incurred, as a result of the Company's decision to exclude
such Holder from any underwritten registration if such Holder has not complied
with the provisions of this Section 5 in all material respects.

          6. Selection of Underwriters. The Holders of Transfer Restricted
Securities covered by the Shelf Registration Statement who desire to do so may
sell the securities covered by such Shelf Registration in an underwritten
offering. In any such underwritten offering, the managing underwriter or
underwriters and manager or managers that will administer the offering will be
selected by the Holders of a majority in aggregate principal amount of the
Transfer Restricted Securities covered by the Shelf Registration Statement;
provided, however, that such underwriters and managers must be reasonably
satisfactory to the Company.

          7. Miscellaneous.

          (a) Reporting Requirement. So long as any of the Transfer Restricted
Securities are outstanding, the Company will comply with the provisions of
Section 2.6 of the Indenture.

          (b) No Inconsistent Agreements. The rights granted to the Holders
hereunder do not, and will not for the term of this Agreement in any way
conflict with and are not, and will not during the term of this Agreement be
inconsistent with the rights granted to the holders of the Company's other
issued and outstanding securities under any other agreements entered into by the
Company.

          (c) Amendments and Waivers. The provisions of this Agreement,
including provisions of this sentence, may not be amended, modified or
supplemented, and waivers or consents to departures from the provisions hereof
may not be given, otherwise than with the prior written consent of the Company
and the Majority Holders affected by such amendment, modification,
supplementation or waiver; provided, however, that no amendment, modification,
or supplement or waiver or consent to the departure with respect to the
provisions of Section 4 hereof shall be effective as against any Holder of
Transfer Restricted Securities or the Company unless consented to in writing by
such Holder of Transfer Restricted Securities or the Company, as the case may
be.

          (d) Notices. (i) All notices and other communications provided for or
permitted hereunder shall be made in writing by hand-delivery, registered
first-class mail, facsimile, or any courier guaranteeing overnight delivery (A)
if to a Holder, at the most current address given by such Holder to the Company
by means of a notice given in accordance with the provisions of this Section
7(d), which address initially is, with respect to the Initial Purchasers, the
address set forth in the Purchase Agreement; and (B) if to the Company,
initially at the

<PAGE>

                                      -26-

Company's address set forth in the Purchase Agreement and thereafter at such
other address, notice of which is given in accordance with the provisions of
this Section 7(d).

          (ii) All such notices and communications shall be deemed to have been
     duly given: at the time delivered by hand, if personally delivered; three
     Business Days after being deposited in the mail, postage prepaid, if
     mailed; when receipt is confirmed, if sent by facsimile; and on the next
     Business Day, if timely delivered to an air courier guaranteeing overnight
     delivery.

          (iii) Copies of all such notices, demands, or other communications
     shall be concurrently delivered by the Person giving the same to the
     Trustee, at the address specified in the Indenture.

          (e) Successors and Assigns. This Agreement shall inure to the benefit
of and be binding upon the successors, assigns and transferees of the Company
and the Initial Purchasers, including, without limitation and without the need
for an express assignment, subsequent Holders. If any transferee of any Holder
shall acquire Transfer Restricted Securities, in any manner, whether by
operation of law or otherwise, such Transfer Restricted Securities shall be held
subject to all of the terms of this Agreement, and by taking and holding such
Transfer Restricted Securities, such Person shall be conclusively deemed to have
agreed to be bound by and to perform all of the terms and provisions of this
Agreement and such Person shall be entitled to receive the benefits hereof.

          (f) Third Party Beneficiary. Each Holder shall be a third party
beneficiary of the agreements made hereunder between the Company, on the one
hand, and the Initial Purchasers, on the other hand, and shall have the right to
enforce such agreements directly to the extent it deems such enforcement
necessary or advisable to protect its rights or the rights of Holders hereunder.

          (g) Counterparts. This Agreement may be executed in any number of
counterparts and by the parties hereto in separate counterparts, each of which
when so executed shall be deemed to be an original and all of which taken
together shall constitute one and the same agreement.

          (h) Headings. The headings in this Agreement are for convenience of
reference only and shall not limit or otherwise affect the meaning hereof.

          (i) GOVERNING LAW. THIS AGREEMENT SHALL BE GOVERNED BY AND CONSTRUED
IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK, WITHOUT GIVING EFFECT TO
ANY PROVISIONS RELATING TO CONFLICTS OF LAWS. All specified times of day refer
to New York City time.

<PAGE>

                                      -27-

          (j) Severability. In the event that any one or more of the provisions
contained herein, or the application thereof in any circumstance, is held
invalid, illegal or unenforceable, the validity, legality and enforceability of
any such provision in every other respect and of the remaining provisions
contained herein shall not be affected or impaired thereby.

          (k) Securities Held by the Company or Any of its Affiliates. Whenever
the consent or approval of Holders of a specified percentage of Transfer
Restricted Securities is required hereunder, Transfer Restricted Securities held
by the Company or any of its affiliates (as such term is defined in Rule 405
under the Securities Act) shall not be counted in determining whether such
consent or approval was given by the Holders of such required percentage.

                            [Signature Pages Follow]

<PAGE>

          IN WITNESS WHEREOF, the parties have executed this Agreement as of the
date first written above.

                                    TRIAD HOSPITALS, INC.

                                    By: /s/ James R. Bedenbaugh
                                        ----------------------------------------
                                        Name:  James R. Bedenbaugh
                                        Title: Senior Vice President & Treasurer

<PAGE>

Confirmed and accepted as of the date first written above:

MERRILL LYNCH & CO.

MERRILL LYNCH, PIERCE, FENNER & SMITH
     INCORPORATED
BANC OF AMERICA SECURITIES LLC

By: Merrill Lynch, Pierce, Fenner & Smith
    Incorporated

     By:   /s/ M. Toby King
         -------------------------------
         Name:  M. Toby King
         Title: Vice-President

By: Banc of America Securities LLC

     By:  /s/ Robert L. Parker
        --------------------------------
        Name:  Robert L. Parker
        Title: MD

          For themselves and as Representatives of the other Initial Purchasers
named in Schedule A hereto.

<PAGE>

                                   SCHEDULE A

Merrill Lynch, Pierce Fenner & Smith
     Incorporated
Banc of America Securities LLC
Citigroup Global Markets Inc.
Credit Suisse First Boston LLC
Goldman, Sachs & Co.
Credit Lyonnais Securities (USA) Inc.
Fleet Securities, Inc.
J.P. Morgan Securities Inc.
Scotia Capital (USA) Inc.
SunTrust Capital Markets, Inc.
Wachovia Capital Markets, LLC
Bear, Stearns & Co. Inc.
Lehman Brothers Inc.
Morgan Stanley & Co. Incorporated
BOSC, Inc.
Stephens Inc.

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