Document:

Form of Stock Certificate

 EXHIBIT 4.16 
  

					
	COMMON STOCK	 	

	 	 COMMON STOCK
 $0.001 PAR VALUE

  

					
	INCORPORATED UNDER THE LAWS	  	 	  	CUSIP [            ]
	OF THE STATE OF DELAWARE	  	 	  	SEE REVERSE FOR CERTAIN DEFINITIONS
			
	 	  	ALLION HEALTH CARE, INC.	  	 

  
 THIS CERTIFIES THAT 
  
 IS THE OWNER OF 
  
 FULLY PAID AND NONASSESSABLE SHARES OF ALLION HEALTH CARE, INC. 
  
 transferable on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon surrender of this
certificate properly endorsed. 
  
 This Certificate is not valid
until countersigned by the Transfer Agent and Registrar. Witness the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. 
  
 Dated: 

					
	 [CORPORATE SEAL]

	 SECRETARY
  
 CHAIRMAN, CHIEF
 EXECUTIVE OFFICER AND
PRESIDENT
	  	BY	  	 COUNTERSIGNED AND REGISTERED:
  

TRANSFER AGENT AND REGISTRAR
 AUTHORIZED
SIGNATURE

	

 This Corporation will furnish without charge to each stockholder who so requests a statement of the
powers, designations, preferences and relative, participating, optional or other special rights of each class of stock or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights. 
  
 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 survivorship and not as tenants in common	  	 	  	 	  	under Uniform Gifts to Minors Act	  	 
	 	 	 	  	 	  	 	  	

	 	 	 	  	 	  	 	  	 	  	(State)	  	 
	 	 	 	  	Additional abbreviations may also be used though not in the above list.	  	 

  
 For Value Received,
                                        
                         hereby sell(s), assign(s) and transfer(s) unto 
  
 PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE 
  

	
	

	(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)
	  

	
	  

  

			
	  

	 	Shares

  

	
	of the capital stock represented by the within Certificate, and do hereby irrevocably constitute and appoint

  

			
	  

	 	Attorney 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(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE
WHATEVER.
	
	Signature(s) Guaranteed
	
	

	
	 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 S.E.C. RULE 174d–15.
  

	 2Amendment to Registration Rights Agreement, dated as of May 19, 2005

 Exhibit 10.15A 
  
  
 AMENDMENT TO REGISTRATION RIGHTS AGREEMENT

  
 This AMENDMENT TO REGISTRATION RIGHTS AGREEMENT is dated
as of May 19, 2005 (this “Amendment”), between Allion Healthcare, Inc., a Delaware corporation (“Allion”), and Michael Stone and Jonathan Spanier (together, the “Warrant Holders”). Capitalized term used but not defined
herein shall have the respective meanings ascribed to them in the Registration Rights Agreement, dated as of January 4, 2005 (the “Agreement”) by and among Allion and the Warrant Holders. 
  
 RECITALS 
  
 WHEREAS, pursuant to a Stock Purchase Agreement, dated as of January 4, 2005, by and among MOMS Pharmacy, Inc., a
California corporation, and the Warrant Holders (the “Stock Purchase Agreement”), the Warrant Holders were issued warrants to purchase an aggregate of 150,000 shares of the common stock of Allion; 
  
 WHEREAS, the parties to this Amendment are all of the parties to the
Agreement; and 
  
 WHEREAS, the parties hereto desire to
make certain amendments to the Agreement in accordance with Section 14 thereof. 
  
 NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties to this Amendment hereby agree as follows: 
  
 1. Amendment to the Agreement. Section 1 of the Agreement is hereby deleted and
replaced in its entirety with the following: 
  
 “Request
for Registration. At any time after Allion has effected an initial public offering of its equity securities pursuant to a registration statement under the Securities Act of 1933, as amended (the “Securities Act”), the Warrant Holders
shall have the right, by written notice signed by both Warrant Holders and given to Allion (the “Demand Notice”), to request that Allion register all of the Warrant Holders’ Registrable Shares under and in accordance with the
provisions of the Securities Act (a “Demand Registration”); provided that the Warrant Holders may not issue a Demand Notice prior to December 17, 2005. Allion shall as soon as practicable, but in no event more than 90 days after the date
on which Allion receives the Demand Notice, file with the Securities and Exchange Commission (the “SEC”) a registration statement on a form deemed appropriate by Allion’s counsel covering all the Warrant Holder’s Registrable
Shares, and Allion shall use its reasonable best efforts to cause the registration statement to become effective within 180 days of such filing. In the event that a Demand Registration involves an underwritten offering and the managing underwriter
or underwriters participating in such offering advise the Warrant Holders in writing that the total number of Registrable Shares to be included in such offering exceeds the amount that can be sold in (or during the time of) such offering without
delaying or jeopardizing the success of such offering (including the price per share of the Registrable Shares to be sold), then the number of Registrable Shares (which have registration rights with respect to such offering) shall be reduced on a
pro rata basis (based 

 upon the number of shares requested or proposed to be registered by each Warrant Holder, Allion and each other holder of
equity securities of Allion eligible to register its shares in the offering) to a number deemed satisfactory by such managing underwriter or underwriters. In the event that the Warrant Holders are unable to register all of their Registrable Shares
in an underwritten offering effected in response to a Demand Registration, the Warrant Holders shall have the right to make an additional demand for registration of the remaining Registrable Shares on Form S-3 pursuant to Rule 415 under the
Securities Act and shall be entitled to issue an additional Demand Notice for such Demand Registration in accordance with this Section 1. For purposes of this Agreement, “Registrable Shares” means the shares of Common Stock of Allion
issued or issuable upon exercise of the Warrants. Registrable Shares shall cease to be such when (a) a registration statement covering such Registrable Shares has become or been declared effective and they have been disposed of pursuant to that
registration statement, (b) eligible to be sold, transferred or distributed pursuant to or in compliance with Rule 144 (or any similar provision then in force) or any other exemption from registration under the Securities Act, or (c) they have been
otherwise transferred and Allion has delivered new certificates not subject to any stop transfer order or other restriction on transfer and not bearing a legend restricting transfer in the absence of an effective registration statement. 

 
 Allion shall not be obligated to effect a registration pursuant to this
Section 1: 
  
 (a) after Allion has already effected one
registration pursuant to this Section 1 that either did not involve an underwritten offering or involved an underwritten offering in which the Warrant Holders were not subjected to any reduction in the number of Registrable Shares they were entitled
to include in such registration, that registration has been declared or ordered effective and no stop order suspending the effectiveness of that registration statement has been issued within 30 days of that effectiveness (provided that Allion
shall be deemed to have effected a registration pursuant to this Section 1 if it files a registration statement pursuant to this Section 1 and such registration statement is subsequently withdrawn because the Warrant Holders request for any reason
whatsoever that such registration statement be withdrawn); or 
  
 (b) if, at the time it receives a Demand Request, Allion would be required to prepare any financial statements other than those it customarily prepares or Allion determines in good faith in its reasonable judgment that the registration and
offering would interfere with any material financing, acquisition, corporate reorganization or other material corporate transaction or development involving Allion that is pending or contemplated at the time and promptly gives the Warrant Holders
written notice of that determination (in which case Allion shall have the right to defer such filing for a period of not more than 60 days after receipt of the Demand Request). 
  
 2. Effective Time. This Amendment shall become effective upon its execution by all of the parties hereto (the “Effective
Time”). From and after the Effective Time, all references to the Agreement shall be deemed to be references to the Agreement as amended hereby. 
  
 3. Ratification. Except as expressly modified by Section 1 of this Amendment, each term and provision of the Agreement is hereby ratified and confirmed and shall
continue in full force and effect. 
  

 2 

 4. Governing Law. This Amendment shall in all respects be governed by, and construed and enforced in accordance
with, the laws of the State of California, without giving effect to any choice of law or conflict of law rules or provisions (whether of the State of California or any other jurisdiction) that would cause the application of laws of any jurisdiction
other than California. 
  
 5. Entire Agreement. This Amendment constitutes
the full and entire understanding and agreement of the parties with respect to the subject matter hereof, and there are no further or other agreements or undertakings, written or oral, in effect between the parties relating to the subject matter
hereof unless expressly referred to in this Amendment. 
  
 6. Execution in
Counterparts. This Amendment may be executed in any number of counterparts and in separate counterparts, each of which when so executed and delivered shall be deemed to be an original and all of which taken together shall constitute one and the
same instrument. 
  
 [end of text; signature page follows]

  

 3 

 IN WITNESS WHEREOF, the parties hereto have executed this Amendment the day and year first above written.

  

			
	 ALLION HEALTHCARE, INC.

		
	 By:
	 	 /s/ Michael P. Moran

	Name:	 	Michael P. Moran
	Title:	 	President & CEO
		
	 	 	 /s/ Michael Stone

 Name: Michael Stone

		
	 	 	 /s/ Jonathan Spanier

 Name: Jonathan Spanier

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