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THE ONCOLOGY INSTITUTE, INC.
REGISTRATION RIGHTS CONSENT, AMENDMENT, AND WAIVER
    Reference is made to that certain Amended and Restated Registration Rights Agreement, dated as of November 12, 2021, by and among The Oncology Institute, Inc. (f/k/a DFP Healthcare Acquisitions Corp.), a Delaware corporation (the “Company”), DFP Sponsor LLC, a Delaware limited liability company (the “Sponsor”), and each of the Persons listed on the Schedule of Investors therein and each of the other Persons set forth on the Schedule of Investors who, at any time, own securities of the Company and enter into a joinder to the agreement (each an “Investor” and collectively, “Investors”) (the “Existing RRA”).  All capitalized terms used herein and not otherwise defined shall have the respective meanings assigned to such terms in the Existing RRA. 
    Whereas, the Company proposes to enter into that certain Facility Agreement (the “Facility Agreement”), by and among each other Person from time to time party thereto, Deerfield Capital, L.P. (“Deerfield”) as Administrative Agent for the financial institutions from time to time party thereto as “Lenders,” (the “Facility Agreement”), pursuant to which it will conduct a private placement of secured convertible notes (the “Notes”) and warrants (the “Warrants”) to purchase shares of the Company’s common stock (the “Common Stock”), par value $0.0001 per share (the “Notes Offering”);
    Whereas, in connection with the Notes Offering, the Company proposes to enter into a new Registration Rights Agreement (the “New RRA”) substantially in the form attached as Exhibit A hereto with Deerfield, pursuant to which the Company intends to file with the Securities and Exchange Commission under the Securities Act of 1933, as amended, one or more registration statements, prospectuses, amendments or supplements thereto covering the resale of the shares of Common Stock (the “Resale Shares”) issuable upon conversion or exercise of the Notes and Warrants (as so filed and as amended and/or supplemented from time to time, the “Registration Statement”);
Whereas, pursuant to Section 2(h) of the Existing RRA, without the prior written consent of the holders of a majority of the Registrable Securities then outstanding, the Company shall not grant to any Persons the right to request the Company to register any equity securities of the Company, or any securities, options or rights convertible or exchangeable into or exercisable for such securities; and
Whereas, pursuant to Section 3 of the Existing RRA, the Company shall provide certain piggyback and notice rights to the Investors; 
Whereas, pursuant to Section 12(a), the Company shall not enter into any agreement with respect to its securities which is inconsistent with or violates or in any way impairs the rights granted to the Investors in the Existing RRA;
Whereas, the undersigned Investors desire to amend the Existing RRA to correct the definition of “TOI Investors” in the Existing RRA;
Whereas, pursuant to Section 12(d) of the Existing RRA, except as otherwise provided therein, the provisions of the Existing RRA may be amended or waived only with the prior written consent of the Company and the holders of a majority of the Registrable Securities then outstanding; provided, that (i) such majority shall include the Majority Deerfield Investors for so long as the Deerfield Investors hold at least 5% of the outstanding Common Stock on the date of such amendment or waiver (assuming the exercise of all warrants, and the conversion of all preferred stock and other convertible securities, held by the Deerfield Investors without giving effect to any restrictions or limitations on exercise or conversion thereof) and (ii) such majority shall include the Majority TOI Investors for so long as the TOI Investors hold at least 5% of the outstanding Common Stock on the date of such amendment or waiver, provided, further, that no amendment may materially and disproportionately adversely affect the rights of any holder of Registrable Securities compared to other holders of Registrable Securities without the consent of such adversely affected holder; 
    Whereas, the undersigned Investors desire, for and on behalf of all Investors, to consent to the Company entering into the New RRA pursuant to Section 2(h); and

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Whereas, the undersigned Investors desire to (i) waive Section 3 of the Existing RRA with respect to the Registration Statement and related notice rights as provided therein with respect to the filing of the Registration Statement with the Commission and any offering of securities thereunder, and (ii) waive Section 12(a) of the Existing RRA with respect to the New RRA and any terms provided thereunder. 
Now, Therefore, in consideration of the foregoing, the undersigned Investors hereby agree with the Company as follows:
1.Consent to New RRA.
    The undersigned Investors, as the majority holders of Registrable Securities under Section 2(h) of the Existing RRA, hereby consent to the Company entering into the New RRA and the grant of the rights thereunder.
2.Waiver of Notice.
The undersigned Investors hereby permanently and irrevocably waive, for and on behalf of all Investors, any and all rights to notice under the Existing RRA Section 2(h) with respect to the Registration Statement, including without limitation, any amendments and supplements thereto, and combined registration statements therewith, and any offering of securities thereunder.

3.Waiver of Section 3 and Section 12(a).
    The undersigned Investors hereby, for themselves as of the date hereof, and, to the extent additional Investors required to meet the requirements under Section 12(d) agree at a later date, for and on behalf of all Investors, permanently and irrevocably waive Section 3 of the Existing RRA, Section 12(a) of the Existing RRA and all other related or similar rights under the Existing RRA with respect to the Registration Statement, including without limitation, any amendments and supplements thereto, and combined registration statements therewith, and any offering of securities thereunder, and with respect to entry into the New RRA.
4.Amendment to TOI Investors
The undersigned Investors hereby agree to amend and restate the definition of TOI Investors under the Existing RRA to read as follows:

“(x) “TOI Investors” means M33 Growth I L.P., TOI M, LLC, TOI HC I, LLC, Oncology Care Partners, LLC, Jimmy Holdings, Inc., and Agajanian Holdings, LLC and their direct and indirect transferees, if any, who become a party to this Agreement pursuant to Section 12(f) of this Agreement.”

5.Company’s Reasonable Best Efforts
The Company will use its reasonable best efforts to obtain the consent of the applicable Investors required under Section 12(d) of the Existing RRA with respect to (i) the waiver of Section 3 and Section 12(a) of the Existing RRA, and (ii) the amendment to the definition of “TOI Investors” in the Existing RRA.

6.Miscellaneous.
Each of the undersigned Investor understands and acknowledges that the Company is relying on this Registration Rights Consent, Amendment, and Waiver and in connection therewith hereby represents and warrants to the Company that (i) such Investor has the full right, power and authority to execute and deliver this Registration Rights Consent, Amendment, and Waiver, (ii) except as previously disclosed to the Company, such Investor has not sold, transferred or otherwise disposed of any Registrable Securities prior to the date of execution of this Registration Rights Consent, Amendment, and Waiver by such Investor, and (iii) this Registration Rights Consent, Amendment, and Waiver has been duly executed and delivered by such Investor and constitutes the legal, valid and binding obligation thereof.

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This Registration Rights Consent, Amendment, and Waiver may be executed in two or more counterparts, each of which shall be deemed an original but all of which shall constitute the same Registration Rights Consent, Amendment, and Waiver. This Registration Rights Consent, Amendment, and Waiver is being signed by each undersigned Investor with respect to all Registrable Securities held by the same, as a stockholder of the Company and for all other purposes. This Registration Rights Consent, Amendment, and Waiver is irrevocable and shall be effective with respect to each of the undersigned Investors and all affiliates, successors, heirs, personal representatives, and assigns of the undersigned Investors. This Registration Rights Consent, Amendment, and Waiver shall be governed by and construed in accordance with the laws of the State of Delaware without reference to its principles of conflict of laws that would result in the application of the laws of any other jurisdiction. Whenever possible, each provision of this Registration Rights Consent, Amendment, and Waiver shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Registration Rights Consent, Amendment, and Waiver is held to be prohibited by or invalid, illegal or unenforceable in any respect under any applicable law, such provision shall be ineffective only to the extent of such prohibition, invalidity, illegality or unenforceability, without invalidating the remainder of this Registration Rights Consent, Amendment, and Waiver.

[Signature Pages Follow]

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    In Witness Whereof, the Company and each of the undersigned Investors has executed this Registration Rights Consent, Amendment, and Waiver on the dates set forth below.

						
	Date: August 9, 2022	Deerfield Private Design Fund IV, L.P.
By:  Deerfield Mgmt IV, L.P., Its General Partner
By:  J.E. Flynn Capital IV, LLC, Its General Partner

By: /s/ David Clark
_____________________________________
Name: David Clark
Title: Authorized Signatory

	Date: August 9, 2022	Deerfield Partners, L.P.
By:  Deerfield Mgmt, L.P., Its General Partner
By:  J.E. Flynn Capital IV, LLC, Its General Partner

By: /s/ David Clark
_____________________________________
Name: David Clark
Title: Authorized Signatory

	Date: August 9, 2022	M33 Growth I L.P.

By:  /s/ Gabriel Ling
_____________________________________
Name:  Gabriel Ling
Title:    Managing Director

[Signature Page to Registration Rights Waiver]

 

						
	Date: August 9, 2022	TOI M, LLC

By:  /s/ Gabriel Ling
_____________________________________
Name:  Gabriel Ling
Title:    Authorized Person

	Date: August 5, 2022	Oncology Care Partners, LLC

By:  /s/ Ravi Sarin
_____________________________________
Name:  Ravi Sarin  
Title:    Member

[Signature Page to Registration Rights Consent]

 

Acknowledged and Agreed:

The Oncology Institute, Inc.

By:  /s/ Mark Hueppelsheuser
    
Name: Mark Hueppelsheuser
Title:   General Counsel
[Signature Page to Registration Rights Waiver]

 

EXHIBIT A
[Signature Page to Registration Rights Waiver]Exhibit 4.1

 

Amended
and restated Promissory Note

 

	U.S. $1,600,0001	January 18, 2018

 

 

The undersigned maker, Forward
Industries Inc, a New York Corporation (“Borrower”) promises to pay to the order of Forward Industries (Asia-Pacific)
Corporation (“Lender”), at 101, Building 13, Bishui Laintian,, New Century Villas, Dongguan City, Guandong Province,
China, 523123, the principal sum of one million six hundred thousand Dollars (U.S. $1,600,000), together with interest accruing thereon
from the date hereof at the rate and time hereinafter provided.

 

Interest (computed on the
basis of a 360-day year for the actual number of days elapsed) on the outstanding balance of principal evidenced by this Note shall accrue
at a rate per annum (the “Applicable Interest Rate”) equal to eight percent (8%).

 

Interest only shall be due
and payable on February 18, 2018, and on the 18th day (or 17th on the maturity date) of each month thereafter until
December 31, 2023, at which time the entire principal and all accrued interest hereunder shall be immediately due and payable in full.

 

The failure of Borrower to
pay to Lender promptly within five (5) days after written notice from Lender that amounts are due and payable under this Note shall constitute
an event or default under this Note. At any time after the occurrence of any such event of default, the indebtedness evidenced by this
Note and/or any note(s) or other obligation(s) which may be taken in renewal, extension, substitution or modification of all or any part
of the indebtedness evidenced thereby and all other obligations of Borrower to Lender howsoever created and existing shall, at the option
of the Lender in its sole discretion, immediately become due and payable without demand upon or notice to Borrower, and Lender shall be
entitled to exercise all remedies as provided by law and/or equity.

 

Borrower hereby waives presentment
for payment, demand, notice of dishonor and protest and agrees that (i) any collateral, lien or right of setoff securing any indebtedness
evidenced by this Note may, from time to time, in whole or in part, be exchanged or released, and any person liable on or with respect
to this Note may be released, all without notice to or further reservations of rights against Borrower, any endorser, surety or guarantor
and all without in any way affecting or releasing the liability of Borrower, any endorser, surety or guarantor, and (ii) none of the terms
or provisions hereof may be waived, altered, modified or amended except as Lender may consent thereto in writing.

 

Borrower hereby agrees to
pay all out-of-pocket costs and expenses, including reasonable attorneys’ fees, incurred by Lender in the collection of the indebtedness
evidenced by this Note, in enforcing any of the rights, powers, remedies and privileges of Lender hereunder, or in connection with any
further negotiations, modifications, releases, or otherwise incurred by Lender in connection with this Note. As used in this Note, the
term “attorneys’ fees” shall mean reasonable charges and expenses for legal services rendered to or on behalf of Lender
in connection with the collection of the indebtedness evidenced by this Note at any time whether prior to the commencement of judicial
proceedings and/or thereafter at the trial and/or appellate level and/or in pre-judgment and post-judgment or bankruptcy proceedings.

 

In no event shall the rate
of interest charged under this Note exceed the rate that may legally be charged to Borrower for obligations of this nature under the laws
of the State of Florida, and any interest that may be paid in excess of the legal limit shall, at the option of Lender, be refunded to
Borrower or shall be applied towards payment of the principal obligation under this Note.

 

If any installment of interest,
principal or principal and interest shall become overdue for a period in excess of ten (10) days, in addition to such payment, a “late
charge” in the amount of five percent (5%) of such overdue payment shall be paid by Borrower to Lender on demand for the purpose
of defraying the expenses incident to handling such delinquent payments.

 

 

 

1
As for the filing date of the Form 10-Q for the quarter ended June 30, 2022, the principal had been reduced to $1,450,000.

 

    	 	1	 

     

    

 

During the continuation of
any default by Borrower in the payment of any installment of interest, principal or principal and interest under this Note, the interest
rate provided herein shall be increased to a rate which shall be equal to the maximum rate of interest allowable under the laws of the
State of Florida. Venue of any litigation arising in connection with this Note shall be in Palm Beach County, Florida.

 

To the extent that Lender
receives any payment on account of any of Borrower’s obligations, and any such payment(s) or any part thereof are subsequently invalidated,
declared to be fraudulent or preferential, set aside, subordinate and/or required to be repaid to a trustee, receiver or any other person
or entity under any bankruptcy act, state or federal law, common law or equitable cause, then, to the extent of such payment(s) received,
Borrower’s obligations or part thereof intended to be satisfied shall be revived and continue in full force and effect, as if such
payment(s) had not been received by Lender and applied on account of Borrower’s obligations.

 

Borrower agrees that this
Note shall be deemed to have been made under and shall be governed by the laws of the State of Florida in all respects, including matters
of construction, validity and performance. If any provisions of this Note shall be deemed unenforceable under applicable law, such provision
shall be ineffective, but only to the extent of such unenforceability, without invalidating the remainder of such provision or the remaining
provisions of this Note. All of the terms and provisions of this Note shall be applicable to and be binding upon each and every maker,
endorser, surety, guarantor, all other persons who are or may become liable for the payment hereof and their heirs, personal representatives,
successors or assigns.

 

BORROWER AND LENDER (BY ACCEPTING
THIS NOTE) HEREBY MUTUALLY WAIVE TRIAL BY JURY IN ANY ACTION, PROCEEDING OR COUNTERCLAIM BROUGHT BY EITHER BORROWER OR LENDER AGAINST
THE OTHER AND BASED UPON, ARISING OUT OF, OR IN CONNECTION WITH, THIS NOTE OR OTHER DOCUMENTS EXECUTED IN CONNECTION WITH THE LOAN EVIDENCED
BY THIS NOTE.

 

	 	
    FORWARD INDUSTRIES, INC.

     

     

     

    By:___________________________________

    Name: _________________

    Its: Chief Financial Officer

 

 

 

 

 

    	 	2	 

     

    

 

	STATE OF _________________	)
	 	) SS:
	COUNTY OF _______________	)

 

The foregoing Promissory Note
was acknowledged before me this _____ day of _______________, 20__, by ____________________, the _______________ of _______________

____________________________________, a ____________________,
on behalf of the _______________, (    ) who is personally known to me OR (    ) who
produced ____________________________________________________________ as identification.

 

 

____________________________________

Notary Signature

 

____________________________________

Print Notary Name

 

NOTARY PUBLIC

State of _______________ at
Large

 

My Commission Expires:

 

 

 

 

 

 

 

 

 

 

Promissory Note Signature Page

 

    	 	3

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