Document:

EX-4.1

 Exhibit 4.1 
  

 
 SPECIMEN SPECIMEN NUMBER SHARES INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE SEE REVERSE FOR CERTAIN DEFINITIONS C o M M o n s T
o C K CUSIP This CerTifies ThaT: SPECIMEN—NOT NEGOTIABLE is The owner of FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF $0.01 PAR VALUE EACH OF AmericAn Well corporAtion transferable on the books
of the Corporation by the holder thereof in person or by duly authorized attorney upon surrender of this certificate duly endorsed or assigned. This certificate and the shares represented hereby are subject to the laws of the State of Delaware, and
to the Certificate of Incorporation and Bylaws of the Corporation, as now or hereafter amended. This certificate is not valid until countersigned by the Transfer Agent. WITNESS the facsimile seal of the Corporation and the facsimile signatures of
its duly authorized officers. COUNTERSIGNED: BROADRIDGE CORPORATE ISSUER SOLUTIONS, INC. DATED: TRANSFER AGENT BY: AUTHORIZED SIGNATURE SPECIMEN NOT NEGOTIABLE SENIOR VICE PRESIDENT & GENERAL COUNSEL CHAIRMAN & CO-CHIEF EXECUTIVE OFFICER 

 

 
 The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were
written out in full according to applicable laws or regulations: TEN COM - as tenants in common UNIF GIFT MIN ACT—....................Custodian.................... TEN ENT—as tenants by the entireties (Cust) (Minor) JT TEN - as joint
tenants with right of under Uniform Gifts to Minors survivorship and not as tenants Act ................................................... in common (State) Additional abbreviations may also be used though not in the above list. For Value Received,
hereby sell, assign and transfer unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (PLEASE PRINT OR TYPE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) Shares of the stock represented by the within Certificate, and do
hereby irrevocably constitute and appoint Attorney to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. Dated NOTICE: THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME
AS WRITTEN UPON THE FACE Signature(s) Guaranteed OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER. By The Signature(s) must be guaranteed by an eligible guarantor institution (Banks, Stockbrokers,
Savings and Loan Associations and Credit Unions with membership in an approved Signature Guarantee Medallion Program), pursuant to SEC Rule 17Ad-15. THE CORPORATION WILL FURNISH TO ANY STOCKHOLDER, UPON
REQUEST AND WITHOUT CHARGE, A FULL STATEMENT OF THE DESIGNATIONS, RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS OF THE SHARES OF EACH CLASS AND SERIES AUTHORIZED TO BE ISSUED, SO FAR AS THE SAME HAVE BEEN DETERMINED, AND OF THE AUTHORITY, IF ANY, OF
THE BOARD TO DIVIDE THE SHARES INTO CLASSES OR SERIES AND TO DETERMINE AND CHANGE THE RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS OF ANY CLASS OR SERIES. SUCH REQUEST MAY BE MADE TO THE SECRETARY OF THE CORPORATION OR TO THE TRANSFER AGENT NAMED ON
THIS CERTIFICATE. COLUMBIA PRINTING SERVICES, LLC—www.stockinformation.comEX-10.2

 Exhibit 10.2 

NON-QUALIFIED STOCK OPTION AGREEMENT 

AMERICAN WELL CORPORATION 
 AGREEMENT (this
“Agreement”) made as of
                                         
           , between American Well Corporation (the “Company”), a Delaware corporation having a principal place of business in Boston, Massachusetts, and
                                         
                    (the “Participant”). 

WHEREAS, the Company desires to grant to the Participant an Option to purchase shares of its common stock, $0.01 par value per share (the
“Shares”), under and for the purposes set forth in the Company’s 2006 Employee, Director and Consultant Stock Plan (the “Plan”); 

WHEREAS, the Company and the Participant understand and agree that any terms used and not defined herein have the same meanings as in the
Plan; and 
 WHEREAS, the Company and the Participant each intend that the Option granted herein shall be a
Non-Qualified Option. 
 NOW, THEREFORE, in consideration of the mutual covenants hereinafter set
forth and for other good and valuable consideration, the parties hereto agree as follows: 
 1. GRANT OF OPTION. 

The Company hereby grants to the Participant the right and option to purchase all or any part of an aggregate of
                                         
        Shares, on the terms and conditions and subject to all the limitations set forth herein, under United States securities and tax laws, and in the Plan, which is incorporated herein by reference. The
Participant acknowledges receipt of a copy of the Plan. 
 2. PURCHASE PRICE. 

The purchase price of the Shares covered by the Option shall be
                                         
    per Share (which is the fair market value of a Share on the date of grant), subject to adjustment, as provided in the Plan, in the event of a stock split, reverse stock split or other events affecting the holders of Shares after
the date hereof (the “Purchase Price”). Payment shall be made in accordance with Paragraph 8 of the Plan. 

 3. VESTING AND EXERCISABILITY OF OPTION. 

Subject to the terms and conditions set forth in this Agreement and the Plan, the Option granted hereby shall become vested and exercisable as
follows: 

                          
                           

4. TERM OF OPTION. The foregoing rights are cumulative and are subject to the other terms and conditions of this Agreement and the Plan. 

The Option shall terminate ten (10) years from the date of this Agreement, but shall be subject to earlier termination as provided herein
or in the Plan. 
 If the Participant ceases to be an employee, director, advisory board member or consultant of the Company or of an
Affiliate (for any reason other than the death or Disability of the Participant or termination of the Participant for “cause” (as defined in the Plan), the Option may be exercised, if it has not previously terminated, within three
(3) months after the date the Participant ceases to be an employee. Director, advisory board member or consultant of the Company or an Affiliate, or within the originally prescribed term of the Option. whichever is earlier, but may not be
exercised thereafter. In such event, the Option shall be exercisable only to the extent that the Option has become exercisable and is in effect at the date of such cessation of employment, directorship, advisory board membership or consultancy. 

Notwithstanding the foregoing, in the event of the Participant’s Disability or death within three (3) months after the termination
of employment, directorship, advisory board membership or consultancy, the Participant or the Participant’s Survivors may exercise the Option within one (1) year after the date of the Participant’s termination of employment,
directorship, advisory board membership or consultancy, but in no event after the date of expiration of the term of the Option. 
 In the
event the Participant’s employment, directorship or consultancy is terminated by the Company or an Affiliate for “cause’’ (as defined in the Plan), the Participant’s right to exercise any unexercised portion of this Option
shall cease immediately as of the time the Participant is notified his or her employment, directorship, advisory board membership or consultancy is terminated for “cause”, and this Option shall thereupon terminate. Notwithstanding anything
herein to the contrary, if subsequent to the Participant’s termination, but prior to the exercise of the Option, the Board of Directors of the Company determines that, either prior or subsequent to the Participant’s termination, the
Participant engaged in conduct which would constitute “cause,” then the Participant shall immediately cease to have any right to exercise the Option and this Option shall thereupon terminate. 

 In the event of the Disability of the Participant, as determined in accordance with the
Plan, the Option shall be exercisable within one (1) year after the Participant’s termination of service or, if earlier, within the term originally prescribed by the Option. In such event, the Option shall be exercisable: 

a) to the extent that the Option has become exercisable but has not been exercised as of the date of Disability; and 

b) in the event rights to exercise the Option accrue periodically, to the extent of a pro rata portion through the date of Disability of any
additional vesting rights that would have accrued on the next vesting date had the Participant not become Disabled. The proration shall be based upon the number of days accrued in the current vesting period prior to the date of Disability. 

In the event of the death of the Participant while an employee, director, advisory board member or consultant of the Company or of an
Affiliate, the Option may be exercisable by the Participant’s Survivors within one (1) year after the date of death of the Participant or, if earlier, within the originally prescribed term of the Option. In such event, the Option shall be
exercisable: 
 a) to the extent that the Option has become exercisable but has not been exercised as of the date of death; and 

b) in the event rights to exercise the Option accrue periodically, to the extent of a pro rata portion through the date of death of any
additional vesting rights that would have accrued on the next vesting date had the Participant not died. The proration shall be based upon the number of days accrued in the current vesting period prior to the Participant’s date of death. 

 5. METHOD OF EXERCISING OPTION. 

Subject to the terms and conditions of this Agreement, the Option may be exercised by written notice to the Company or its designee, in
substantially the form of Exhibit A attached hereto. Such notice shall state the number of Shares with respect to which the Option is being exercised and shall be signed by the person exercising the Option. Payment of the purchase price for such
Shares shall be made in accordance with Paragraph 8 of the Plan. The Company shall deliver such Shares as soon as practicable after the notice shall be received, provided, however, that the Company may delay issuance of such Shares until completion
of any action or obtaining of any consent, which the Company deems necessary under any applicable law (including, without limitation, state securities or “blue sky” laws). The Shares as to which the Option shall have been so exercised
shall be registered in the Company’s share register in the name of the person so exercising the Option (or, if the Option shall be exercised by the Participant and if the Participant shall so request in the notice exercising the Option, shall
be registered in the name of the Participant and another person jointly, with right of survivorship) and shall be delivered as provided above to or upon the written order of the person exercising the Option. In the event the Option shall be
exercised, pursuant to Section 4 hereof, by any person other than the Participant, such notice shall be accompanied by appropriate proof of the right of such person to exercise the Option. All Shares that shall be purchased upon the exercise of
the Option as provided herein shall be fully paid and nonassessable. 
 6. PARTIAL EXERCISE. 

Exercise of this Option to the extent above stated may be made in part at any time and from time to time within the above limits, except that
no fractional share shall be issued pursuant to this Option. 
 7. NON-ASSIGNABILITY. 

The Option shall not be transferable by the Participant otherwise than by will or by the laws of descent and distribution or pursuant to a
qualified domestic relations order as defined by the Code or Title I of the Employee Retirement Income Security Act or the rules thereunder. However, the Participant, with the approval of the Administrator, may transfer the Option for no
consideration to or for the benefit of the Participant’s Immediate Family (including, without limitation, to a trust for the benefit of the Participant’s Immediate Family or to a partnership or limited liability company for one or more
members of the Participant’s Immediate Family), subject to such limits as the Administrator may establish, and the transferee shall remain subject to all the terms and conditions applicable to the Option prior to such transfer and each such
transferee shall so acknowledge in writing as a condition precedent to the effectiveness of such transfer. The term “Immediate Family” shall mean the Participant’s spouse, former spouse, parents, children, stepchildren, adoptive
relationships, sisters, brothers, nieces, nephews and grandchildren (and, for this purpose, shall also include the Participant.) Except as provided in the previous sentence, the Option shall be exercisable, during the Participant’s lifetime,
only by the Participant (or, in the event of legal incapacity or incompetency, by the Participant’s guardian or representative) and shall not be assigned, pledged or hypothecated in any way (whether by operation of law or otherwise) and shall
not be subject to execution, attachment or similar process. Any attempted transfer, assignment, pledge, hypothecation or other disposition of the Option or of any rights granted hereunder contrary to the provisions of this Section 7, or the
levy of any attachment or similar process upon the Option shall be null and void. 

 8. NO RIGHTS AS STOCKHOLDER UNTIL EXERCISE. 

The Participant shall have no rights as a stockholder with respect to Shares subject to this Agreement until registration of the Shares in the
Company’s share register in the name of the Participant. Except as is expressly provided in the Plan with respect to certain changes in the capitalization of the Company, no adjustment shall be made for dividends or similar rights for which the
record date is prior to the date of such registration. 
 9. ADJUSTMENTS. 

The Plan contains provisions covering the treatment of Options in a number of contingencies such as stock splits and mergers. Provisions in the
Plan for adjustment with respect to stock subject to Options and the related provisions with respect to successors to the business of the Company are hereby made applicable hereunder and are incorporated herein by reference. 

10. TAXES. 
 The Participant
acknowledges that upon exercise of the Option the Participant will be deemed to have taxable income measured by the difference between the then fair market value of the Shares received upon exercise and the price paid for such Shares pursuant to
this Agreement. The Participant acknowledges that any income or other taxes due from him or her with respect to this Option or the Shares issuable pursuant to this Option shall be the Participant’s responsibility. 

The Participant agrees that the Company may withhold from the Participant’s remuneration, if any, the minimum statutory amount of
federal, state and local withholding taxes attributable to such amount that is considered compensation includable in such person’s gross income. At the Company’s discretion, the amount required to be withheld may be withheld in cash from
such remuneration, or in kind from the Shares otherwise deliverable to the Participant on exercise of the Option. The Participant further agrees that, if the Company does not withhold an amount from the Participant’s remuneration sufficient to
satisfy the Company’s income tax withholding obligation, the Participant will reimburse the Company on demand, in cash, for the amount under-withheld. 

11. PURCHASE FOR INVESTMENT. 

Unless the offering and sale of the Shares to be issued upon the particular exercise of the Option shall have been effectively registered under
the Securities Act of 1933, as now in force or hereafter amended (the “1933 Act”), the Company shall be under no obligation to issue the Shares covered by such exercise unless and until the following conditions have been fulfilled: 

(a) The person(s) who exercise the Option shall warrant to the Company, at the time of such exercise, that such person(s) are acquiring such
Shares for their own respective accounts, for investment, and not with a view to, or for sale in connection with, the distribution of any such Shares, in which event the person(s) acquiring such Shares shall be bound by the provisions of the
following legend which shall be endorsed upon any certificate(s) evidencing the Shares issued pursuant to such exercise: 

 “The shares represented by this certificate have been taken for investment and they may not be sold or
otherwise transferred by any person, including a pledgee, unless (1) either (a) a Registration Statement with respect to such shares shall be effective under the Securities Act of 1933, as amended, or (b) the Company shall have received an
opinion of counsel satisfactory to it that an exemption from registration under such Act is then available, and (2) there shall have been compliance with all applicable state securities laws;” and 

(b) If the Company so requires, the Company shall have received an opinion of its counsel that the Shares may be issued upon such particular
exercise in compliance with the 1933 Act without registration thereunder. Without limiting the generality of the foregoing, the Company may delay issuance of the Shares until completion of any action or obtaining of any consent, which the Company
deems necessary under any applicable law (including without limitation state securities or “blue sky” laws). 
 12. RESTRICTIONS ON
TRANSFER OF SHARES. 
 12.1 The Shares acquired by the Participant pursuant to the exercise of the Option granted hereby shall not be
transferred by the Participant except as permitted herein. 
 12.2 In the event of the Participant’s termination of service for any
reason, the Company shall have the option, but not the obligation, to repurchase all or any part of the Shares issued pursuant to this Agreement (including, without limitation, Shares purchased after termination of employment, Disability or death in
accordance with Section 4 hereof). In the event the Company does not, upon the termination of service of the Participant (as described above), exercise its option pursuant to this Section 12.2, the restrictions set forth in the balance of
this Agreement shall not thereby lapse, and the Participant for himself or herself his or her heirs. Legatees, executors, administrators and other successors in interest, agrees that the Shares shall remain subject to such restrictions. The
following provisions shall apply to a repurchase under this Section 12.2: 
 (i) The per share repurchase price of the Shares to be sold
to the Company upon exercise of its option under this Section 1 2.2 shall be equal to the Fair Market Value of each such Share determined in accordance with the Plan as of the date of termination of service. Provided, however, in the event of a
termination by the Company for “cause” (as defined in the Plan), the per share repurchase price of the Shares to be sold to the Company upon exercise of its option under this Section 12.2 shall be equal to the Purchase Price. 

 (ii) The Company’s option to repurchase the Participant’s Shares in the event of
termination of service shall be valid for a period of (eighteen) 1 8 month s commencing with the date of such termination of service. 

(iii) In the event the Company shall be entitled to and shall elect to exercise its option to repurchase the Par1icipant’s Shares under
this Section 12.2, the Company shall notify the Participant, or in case of death, his or her Survivor, in writing of its intent to repurchase the Shares. Such written notice may be mailed by the Company up to and including the last day of the
time period provided for in Section 12.2(ii) for exercise of the Company’s option to repurchase. 
 (iv) The written notice to the
Participant shall specify the address at, and the time and date on, which payment of the repurchase price is to be made (the “Closing”). The date specified shall not be less than ten (10) days nor more than sixty (60) days from
the date of the mailing of the notice, and the Par1icipant or hi s or her successor in interest with respect to the Shares shall have no further right s as the owner thereof from and after the date specified in the notice. At the Closing, the
repurchase price shall be delivered to the Participant or his or her successor in interest and the Shares being purchased, duly endorsed for transfer. Shall, to the extent that they are not then in the possession of the Company, be delivered to the
Company by the Participant or his or her successor in interest. 
 12.2 It shall be a condition precedent to the validity of any sale or
other transfer of any Shares by the Participant that the following restrictions are complied with (except as hereinafter otherwise provided): 

(i) No Shares owned by the Participant may be sold, pledged or otherwise transferred (including by gift or devise) to any person or entity,
voluntarily, or by operation of law, except in accordance with the terms and conditions hereinafter set forth. 
 (ii) Before selling or
otherwise transferring all or part of the Shares, the Participant shall give written notice of such intention to the Company, which notice shall include the name of the proposed transferee, the proposed purchase price per share, the terms of payment
of such purchase price and all other matters relating to such sale or transfer and shall be accompanied by a copy of the binding written agreement of the proposed transferee to purchase the Shares of the Participant. Such notice shall constitute a
binding offer by the Participant to sell to the Company such number of the Shares then held by the Participant as are proposed to be sold in the notice at the monetary price per share designated in such notice, payable on the terms offered to the
Participant by the proposed transferee (provided, however, that the Company shall not be required to meet any non-monetary terms of the proposed transfer, including, without limitation, delivery of other
securities in exchange for the Shares proposed 

 
to be sold). The Company shall give written notice to the Participant as to whether such offer has been accepted in whole by the Company within sixty (60) days after its receipt of written
notice from the Participant. The Company may only accept such offer in whole and may not accept such offer in part. Such acceptance notice shall fix a time, location and date for the closing on such purchase (“Closing Date”) which shall
not be less than ten (10) nor more than sixty (60) days after the giving of the acceptance notice, provided, however, if any of the Shares to be sold pursuant to this Section 12.2 have been held by the Participant for less than six
(6) months, then the Closing Date may be extended by the Company until no more than ten (10) days after such Shares have been held by the Participant for six (6) months. The place for such closing shall be at the Company’s
principal office. At such closing, the Participant shall accept payment as set forth herein and shall deliver to the Company in exchange certificates for the number of Shares stated in the notice accompanied by duly executed instruments of transfer.

 (iii) If the Company shall fail to accept any such offer, the Participant shall be free to sell all, but not less than all, of the Shares
set forth in his or her notice to the designated transferee at the price and terms designated in the Participant’s notice, provided that (i) such sale is consummated within six (6) months after the giving of notice by the Participant
to the Company as aforesaid, and (ii) the transferee first agrees in writing to be bound by the provisions of this Section 12 so that such transferee (and all subsequent transferees) shall thereafter only be permitted to sell or transfer
the Shares in accordance with the terms hereof. After the expiration of such six (6) months, the provisions of this Section 12.2 shall again apply with respect to any proposed voluntary transfer of the Participant’s Shares. 

(iv) The restrictions on transfer contained in this Section 12.2 shall not apply to (a) transfers by the Participant to his or her
spouse or children or to a trust for the benefit of his or her spouse or children, (b) transfers by the Participant to his or her guardian or conservator, and (c) transfers by the Participant, in the event of his or her death, to his or
her executor(s) or administrator(s) or to trustee(s) under his or her will (collectively, “Permitted Transferees”); provided however, that in any such event the Shares so transferred in the hands of each such Permitted Transferee shall
remain subject to this Agreement, and each such Permitted Transferee shall so acknowledge in writing as a condition precedent to the effectiveness of such transfer. 

(v) The provisions of this Section 12.2 may be waived by the Company. Any such waiver may be unconditional or based upon such conditions
as the Company may impose. 
 12.3 In the event that the Participant or his or her successor in interest fails to deliver the Shares to be
repurchased by the Company under this Agreement, the Company may elect (a) to establish a segregated account in the amount of the repurchase price, such account to be turned over to the Participant or his or her successor in interest upon
delivery of such Shares, and (b) immediately to take such action as is appropriate to transfer record title of such Shares from the Participant to the Company and to treat the Participant and such Shares in all respects as if delivery of such
Shares had been made as required by this Agreement. The Participant hereby irrevocably grants the Company a power of attorney which shall be coupled with an interest for the purpose of effectuating the preceding sentence. 

 12.4 If the Company shall pay a stock dividend or declare a stock split on or with respect
to any of its Common Stock, or otherwise distribute securities of the Company to the holders of its Common Stock, the number of shares of stock or other securities of Company issued with respect to the shares then subject to the restrictions
contained in this Agreement shall be added to the Shares subject to the Company’s rights to repurchase pursuant to this Agreement. If the Company shall distribute to its stockholders shares of stock of another corporation, the shares of stock
of such other corporation, distributed with respect to the Shares then subject to the restrictions contained in this Agreement, shall be added to the Shares subject to the Company’s rights to repurchase pursuant to this Agreement. 

12.5 If the outstanding shares of Common Stock of the Company shall be subdivided into a greater number of shares or combined into a smaller
number of shares, or in the event of a reclassification of the outstanding shares of Common Stock of the Company, or if the Company shall be a party to a merger, consolidation or capital reorganization, there shall be substituted for the Shares then
subject to the restrictions contained in this Agreement such amount and kind of securities as are issued in such subdivision, combination, reclassification, merger, consolidation or capital reorganization in respect of the Shares subject immediately
prior thereto to the Company’s rights to repurchase pursuant to this Agreement. 
 12.6 The Company shall not be required to transfer
any Shares on its books which shall have been sold, assigned or otherwise transferred in violation of this Agreement, or to treat as owner of such Shares, or to accord the right to vote as such owner or to pay dividends to, any person or
organization to which any such Shares shall have been so sold, assigned or otherwise transferred, in violation of this Agreement. 
 12.7 The
provisions of Sections 12.1, 12.2 and 12.3 shall terminate upon the effective date of the registration of the Shares pursuant to the Securities Exchange Act of 1934. 

12.8 If, in connection with a registration statement filed by the Company pursuant to the 1933 Act, the Company or its underwriter so requests,
the Participant will agree not to sell any Shares for a period not to exceed 180 days following the effectiveness of such registration plus such additional period of time as may be required to comply with Marketplace Rule 2711 of the National
Association of Securities Dealers, Inc. or similar rules thereto. 

 12.9 The Participant acknowledges and agrees that neither the Company, its shareholders nor
its directors and officers, has any duty or obligation to disclose to the Participant any material information regarding the business of the Company or affecting the value of the Shares before, at the time of, or following a termination of the
employment of the Participant by the Company, including, without limitation, any information concerning plans for the Company to make a public offering of its securities or to be acquired by or merged with or into another firm or entity. 

12.10 All certificates representing the Shares to be issued to the Participant pursuant to this Agreement shall have endorsed thereon a legend
substantially as follows: “The shares represented by this certificate are subject to restrictions set forth in a Non-Qualified Stock Option Agreement dated
                                         
        with this Company, a copy of which Agreement is available for inspection at the offices of the Company or will be made available upon request.” 

13. NO OBLIGATION TO MAINTAIN RELATIONSHIP. 

The Company is not by the Plan or this Option obligated to continue the Participant as an employee, director or consultant of the Company or an
Affiliate. The Participant acknowledges: (i) that the Plan is discretionary in nature and may be suspended or terminated by the Company at any time; (ii) that the grant of the Option is a one-time
benefit which does not create any contractual or other right to receive future grants of options, or benefits in lieu of options; (iii) that all determinations with respect to any such future grants, including, but not limited to, the times
when options shall be granted, the number of shares subject to each option, the option price, and the time or times when each option shall be exercisable, will be at the sole discretion of the Company; (iv) that the Participant’s
participation in the Plan is voluntary; (v) that the value of the Option is an extraordinary item of compensation which is outside the scope of the Participant’s employment contract, if any; and (vi) that the Option is not part of
normal or expected compensation for purposes of calculating any severance, resignation, redundancy, end of service payments, bonuses, long-service awards, pension or retirement benefits or similar payments. 

14. NOTICES. 
 Any notices
required or permitted by the terms of this Agreement or the Plan shall be given by recognized courier service, facsimile, registered or certified mail, return receipt requested, addressed as follows: 

If to the Company: 
 American
Well Corporation 
 75 State Street, 26th Floor 

Boston, MA 02109 
 Attention: Roy
Schoenberg, President and CEO 

 If to the Participant: 

                          
                           

                          
                   
 or to such other address or
addresses of which notice in the same manner has previously been given. Any such notice shall be deemed to have been given upon the earlier of receipt, one business day following delivery to a recognized courier service or three business days
following mailing by registered or certified mail. 
 15. GOVERNING LAW. 

This Agreement shall be construed and enforced in accordance with the law of the State of Delaware, without giving effect to the conflict of
law principles thereof. 
 16. BENEFIT OF AGREEMENT. 

Subject to the provisions of the Plan and the other provisions hereof, this Agreement shall be for the benefit of and shall be binding upon the
heirs, executors, administrators, successors and assigns of the parties hereto. 
 17. ENTIRE AGREEMENT. 

This Agreement, together with the Plan, embodies the entire agreement and understanding between the parties hereto with respect to the subject
matter hereof and supersedes all prior oral or written agreements and understandings relating to the subject matter hereof. No statement, representation, warranty, covenant or agreement not expressly set forth in this Agreement shall affect or be
used to interpret, change or restrict, the express terms and provisions of this Agreement, provided, however, in any event, this Agreement shall be subject to and governed by the Plan. 

18. MODIFICATIONS AND AMENDMENTS. 

The terms and provisions of this Agreement may be modified or amended as provided in the Plan. 

 19. WAIVERS AND CONSENTS. 

Except as provided in the Plan, the terms and provisions of this Agreement may be waived, or consent for the departure therefrom granted, only
by written document executed by the party entitled to the benefits of such terms or provisions. No such waiver or consent shall be deemed to be or shall constitute a waiver or consent with respect to any other terms or provisions of this Agreement,
whether or not similar. Each such waiver or consent shall be effective only in the specific instance and for the purpose for which it was given, and shall not constitute a continuing waiver or consent. 

20. DATA PRIVACY. 
 By entering
into this Agreement, the Participant: (i) authorizes the Company and each Affiliate, and any agent of the Company or any Affiliate administering the Plan or providing Plan recordkeeping services, to disclose to the Company or any of its
Affiliates such information and data as the Company or any such Affiliate shall request in order to facilitate the grant of options and the administration of the Plan; (ii) waives any data privacy rights he or she may have with respect to such
information; and (iii) authorizes the Company and each Affiliate to store and transmit such information in electronic form. 
 21.
CONSENT OF SPOUSE. 
 If the Participant is married as of the date of this Agreement, the Participant’s spouse shall execute a Consent
of Spouse in the form of Exhibit B hereto, effective as of the date hereof. Such consent shall not be deemed to confer or convey to the spouse any rights in the Shares that do not otherwise exist by operation of law or the agreement of the parties.
If the Participant marries or remarries subsequent to the date hereof the Participant shall, not later than sixty (60) days thereafter, obtain his or her new spouse’s acknowledgement of and consent to the existence and binding effect of
Section 12.2 of this Agreement by such spouse’s executing and delivering Consent of Spouse in the form of Exhibit B. 
 [REMAINDER
OF PAGE INTENTIONALLY LEFT BLANK] 

 IN WITNESS WHEREOF, the Company has caused this Agreement to be executed by its duly
authorized officer, and the Participant has hereunto set his or her hand, all as of the day and year first above written. 
 AMERICAN WELL CORPORATION 

 

			
	By:	 	
                     
                       

	Name: Roy Schoenberg
	Title: President & CEO

  

			
	Name:

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