Document:

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                                                                    EXHIBIT 4.11

THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR
INVESTMENT AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE "SECURITIES ACT"), OR ANY STATE SECURITIES LAW. SUCH SECURITIES
MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR UNLESS
THE ISSUER RECEIVES AN OPINION OF COUNSEL SATISFACTORY TO THE ISSUER THAT SUCH
SALE OR TRANSFER IS EXEMPT FROM THE REGISTRATION AND PROSPECTUS DELIVERY
REQUIREMENTS OF THE SECURITIES ACT OR SUCH STATE LAW.

                                 SYMBION, INC.

                     WARRANT FOR THE PURCHASE OF SHARES OF
                                  COMMON STOCK

                                                             ___________ Shares

         FOR VALUE RECEIVED, SYMBION, INC., a Tennessee corporation (the
"COMPANY"), hereby certifies that ________________________________ (the
"HOLDER"), or its permitted registered assigns is entitled to purchase from the
Company, upon the terms and conditions set forth herein, ________________
(____) fully paid and non-assessable shares of common stock, no par value per
share, of the Company for a purchase price per share of $3.13. Hereinafter, (i)
said common stock, no par value per share, of the Company, is referred to as
the "COMMON STOCK," (ii) the shares of the Common Stock purchasable hereunder
are referred to as the "WARRANT SHARES," (iii) the aggregate purchase price
payable for the Warrant Shares purchasable hereunder is referred to as the
"AGGREGATE WARRANT PRICE," (iv) the price payable for each of the Warrant
Shares hereunder is referred to as the "PER SHARE WARRANT PRICE," (v) this
Warrant and all warrants hereafter issued in exchange or substitution for this
Warrant are referred to as the "WARRANTS," and (vi) the then Current Market
Price per share of the Common Stock (the "CURRENT MARKET PRICE") shall be
deemed to be the last sale price of the Common Stock on the trading day prior
to such date or, in case no such reported sales take place on such day, the
average of the last reported bid and asked prices of the Common Stock on such
day, in either case on the principal national securities exchange on which the
Common Stock is admitted to trading or listed, or if not listed or admitted to
trading on any such exchange, the representative closing sale price of the
Common Stock as reported by the National Association of Securities Dealers,
Inc. Automated Quotations System ("NASDAQ"), or other similar organization if
NASDAQ is no longer reporting such information, or, if the Common Stock is not
reported on NASDAQ, the high per share sale price for the Common Stock in the
over-the-counter market as reported by the National Quotation Bureau or similar
organization, or if not so available, the fair market value of the Common Stock
as determined in good faith by the Board of Directors of the Company (the
"BOARD OF DIRECTORS"). The Aggregate Warrant Price is not subject to
adjustment. The Per Share Warrant Price is subject to adjustment as hereinafter
provided; in the event of any such adjustment, the number of Warrant Shares
deliverable upon exercise of this Warrant shall be adjusted by dividing the
Aggregate Warrant Price by the Per Share Warrant Price in effect immediately
after such adjustment.

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         1.       EXERCISE OF WARRANT.

         (a)      This Warrant may be exercised in whole or in part, but not
for less than 5,000 shares at a time (subject to adjustment as provided in
Section 3 below), from time to time, commencing on the date hereof but prior to
5:00 P.M., Nashville, Tennessee time, on the earlier to occur of (i) March 28,
2005 or (ii) the one (1) year anniversary of the effective date of the first
registration statement for a public offering of securities of the Company or a
successor entity thereof, by the Holder:

                  (i)      by the surrender of this Warrant (with the
subscription form at the end hereof duly executed) at the address set forth in
Section 9(a) hereof, together with proper payment of the Aggregate Warrant
Price, or the proportionate part thereof if this Warrant is exercised in part,
with payment for the Warrant Shares made by certified or official bank check
payable to the order of the Company; or

                  (ii)     on any date on which the Current Market Price
exceeds the Per Share Warrant Price, by the surrender of this Warrant (with the
cashless exercise form at the end hereof duly executed) (a "CASHLESS EXERCISE")
at the address set forth in Section 9(a) hereof. Such presentation and
surrender shall be deemed a release of the Company's obligation to issue
additional Warrant Shares pursuant to this Warrant and waiver of the Company's
right to require Holder to pay the Aggregate Warrant Price, or the
proportionate part thereof if this Warrant is exercised in part. In the event
of a Cashless Exercise, the Holder shall exchange its Warrant for that number
of Warrant Shares subject to such Cashless Exercise multiplied by a fraction,
the numerator of which shall be the excess of the then Current Market Price
over the then Per Share Warrant Price, and the denominator of which shall be
the then Current Market Price. For purposes of any computation under this
Section 1(a)(ii), the then Current Market Price shall be based on the trading
day prior to the Cashless Exercise. Notwithstanding the foregoing, the Company
shall have no obligation to issue Warrant Shares for a consideration less than
the aggregate par value of the Warrant Shares then issued.

         (b)      If this Warrant is exercised in part, this Warrant must be
exercised for a number of whole shares of Common Stock and the Holder is
entitled to receive a new Warrant covering the Warrant Shares that have not
been exercised and setting forth the proportionate part of the Aggregate
Warrant Price applicable to such Warrant Shares. Upon surrender of this
Warrant, the Company will (i) issue a certificate or certificates in the name
of the Holder for the largest number of whole shares of Common Stock to which
the Holder shall be entitled and, if this Warrant is exercised in whole, in
lieu of any fractional share of Common Stock to which the Holder shall be
entitled, pay to the Holder cash in an amount equal to the fair value of such
fractional share (determined in such reasonable manner as the Board of
Directors shall determine), and (ii) deliver the other securities and
properties receivable upon the exercise of this Warrant, or the proportionate
part thereof if this Warrant is exercised in part, pursuant to the provisions
of this Warrant.

         2.       RESERVATION OF WARRANT SHARES.

         The Company agrees that, prior to the expiration of this Warrant, the
Company shall at all times have authorized and in reserve, and shall keep
available, solely for issuance and delivery upon the exercise of this Warrant,
the shares of Common Stock and

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other securities and properties as from time to time shall be receivable upon
the exercise of this Warrant, free and clear of all restrictions on sale or
transfer, other than under Federal or state securities laws.

         3.       PROTECTION AGAINST DILUTION.

         (a)      Stock Distribution, Splits and Combinations; Adjustments. If,
at any time or from time to time after the date of this Warrant, the Company
shall (i) subdivide its outstanding shares of Common Stock into a greater
number of shares (whether by stock dividend or stock split), (ii) combine its
outstanding shares of Common Stock into a smaller number of shares or (iii)
declare a dividend of shares of Common Stock or make any other distribution
payable in shares of Common Stock on its outstanding shares of Common Stock,
the Per Share Warrant Price shall be adjusted to equal the Aggregate Warrant
Price divided by the number of shares of Common Stock or other capital stock of
the Company that the Holder would have owned immediately following such action
had such Warrant been exercised immediately prior thereto. The Holder of this
Warrant shall thereafter be entitled to purchase, at the Per Share Warrant
Price resulting from such adjustment, the number of shares obtained by dividing
the Aggregate Warrant Price by the Per Share Warrant Price resulting from such
adjustment. An adjustment made pursuant to this Subsection 3(a) shall become
effective immediately after the record date in the case of a dividend or
distribution, and shall become effective immediately after the effective date
in the case of a subdivision or combination.

         (b)      Reorganization and Recapitalizations. In case of any capital
reorganization or reclassification (including any change or exchange of its
outstanding Common Stock into a stock with par value to stock with a different
par value or no par value), or any consolidation or merger to which the Company
is a party other than a merger or consolidation in which the Company is the
continuing corporation, or in case of any sale or conveyance to another entity
of the property of the Company as an entirety or substantially as a entirety,
or in the case of any statutory exchange of securities with another corporation
(including any exchange effected in connection with a merger of a third
corporation into the Company) the Holder of this Warrant shall have the right
thereafter to receive on the exercise of this Warrant the kind and amount of
securities, cash or other property which the Holder would have owned or have
been entitled to receive immediately after such reorganization,
reclassification, consolidation, merger, statutory exchange, sale or conveyance
had this Warrant been exercised immediately prior to the effective date of such
reorganization, reclassification, consolidation, merger, statutory exchange,
sale or conveyance and in any such case, if necessary, appropriate adjustment
shall be made in the application of the provisions set forth in this Section 3
with respect to the rights and interests thereafter of the Holder of this
Warrant to the end that the provisions set forth in this Section 3 shall
thereafter correspondingly be made applicable, as nearly as may reasonably be,
in relation to any shares of stock or other securities or property thereafter
deliverable on the exercise of this Warrant. The above provisions of this
Section 3(b) shall similarly apply to successive reorganizations,
reclassifications, consolidations, mergers, statutory exchanges, sales or
conveyances. The Company shall require the issuer of any shares of stock or
other securities or property thereafter deliverable on the exercise of this
Warrant to be responsible for all of the agreements and obligations of the
Company hereunder. A sale of all or substantially all of the assets of the
Company for a consideration

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consisting primarily of securities shall be deemed a consolidation or merger
for the foregoing purposes.

         (c)      Adjustment by Board of Directors. If any event occurs as to
which, in the opinion of the Board of Directors, the provisions of this Section
3 are not strictly applicable or if strictly applicable would not fairly
protect the rights of the Holder of this Warrant in accordance with the
essential intent and principles of such provisions, then the Board of Directors
shall make an adjustment in the application of such provisions, in accordance
with such essential intent and principles, so as to protect such rights as
aforesaid, but in no event shall any adjustment have the effect of increasing
the Aggregate Warrant Price as otherwise determined pursuant to any of the
provisions of this Section 3 except in the case of a combination of shares of a
type contemplated in Section 3(a) and then in no event to an amount larger than
the Aggregate Warrant Price as adjusted pursuant to Section 3(a).

         (d)      Notice of Adjustment. Whenever the Per Share Warrant Price is
adjusted as provided in this Section 3 and upon any modification of the rights
of a Holder of Warrants in accordance with this Section 3, the Company shall
promptly prepare a brief statement of the facts requiring such adjustment or
modification and the manner of computing the same and cause copies of such
certificate to be mailed to the Holder of the Warrants.

         (e)      Notice of a Record Date. In the event of any taking by the
Company of a record date of the holders of any class of securities for the
purpose of determining the holders thereof (i) who are entitled to receive any
dividend (other than a cash dividend payable out of earned surplus of the
Company) or other distribution, or any right to subscribe for, purchase or
otherwise acquire any shares of stock of any other securities or assets, or to
receive any other right, (ii) who are eligible to vote their shares in respect
of any reorganization of the Company, or any reclassification of the capital
stock of the Company, or any transfer of all or substantially all of the assets
of the Company to, or consolidation or merger of the Company with any other
person or (iii) who are eligible to vote their shares in respect of any
voluntary or involuntary dissolution or liquidation of the Company, then in
each such event the Company will mail or cause to be mailed to each Holder a
notice specifying not only the date on which any such record is to be taken for
the purpose of such dividend, distribution or voting right and stating the
amount and character of such dividend or right, but also the date on which such
reorganization, reclassification, recapitalization, transfer, consolidation,
merger, statutory exchange, dissolution, liquidation or winding-up is
reasonably expected to take place, and the time, if any, as of which the
holders of record of Warrant Shares shall be entitled to exchange their shares
of Warrant Shares for securities or other property deliverable upon such
reorganization, reclassification, recapitalization, transfer, consolidation,
merger, statutory exchange, dissolution, liquidation or winding-up. Such notice
shall be given at least ten (10) days prior to the proposed record date therein
specified.

         4.       FULLY PAID STOCK; TAXES. The shares of the Common Stock
represented by each and every certificate for Warrant Shares delivered on the
exercise of this Warrant shall at the time of such delivery, be duly
authorized, validly issued and outstanding, fully paid and nonassessable, and
the Company will take all such actions as may be necessary to assure that the
par value, if any, per share of the Common Stock is at all times equal to or
less than the then Per Share Warrant Price. The Company shall pay, when due and
payable, any and all Federal and state stamp, original issue or similar taxes
which may be

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payable in respect of the issue of any Warrant Share or any certificate thereof
to the extent required because of the issuance by the Company of such security.
The Company will not, however, be required to pay any such taxes imposed in
connection with any transfer of this Warrant or any Warrant Shares or any
federal or state income taxes payable in respect of the purchase, ownership,
sale, transfer, exercise or other disposition of this Warrant or any Warrant
Shares.

         5.       REPRESENTATIONS OF THE HOLDER.

         By accepting this Warrant, the Holder represents and acknowledges to
the Company that:

         (a)      this Warrant and the Warrant Shares will be "RESTRICTED
SECURITIES" as such term is used in the rules and regulations under the
Securities Act and that such securities have not been and will not be
registered under the Securities Act or any state securities law, and that such
securities must be held indefinitely unless registration is effected or
transfer can be made pursuant to appropriate exemptions;

         (b)      the Holder has read, and fully understands, the terms of this
Warrant set forth on its face and the attachments hereto, including the
restrictions on transfer contained herein;

         (c)      the Holder has either a pre-existing business relationship
with the Company or one of its officers, directors or controlling persons;

         (d)      the Holder is purchasing for investment for its own account
and not with a view to or for sale in connection with any distribution of this
Warrant or the Warrant Shares and it has no intention of selling such
securities in a public distribution in violation of the federal securities laws
or any applicable state securities laws; provided that nothing contained herein
will prevent the Holder from transferring such securities in compliance with
the terms of this Warrant and the applicable federal and state securities laws;

         (e)      the Holder is an "accredited investor" within the meaning of
paragraph (a) of Rule 501 of Regulation D promulgated by the Securities and
Exchange Commission (the "COMMISSION"); and

         (f)      the Company may affix the following legend (in addition to
any other legend(s), if any, required by applicable state corporate and/or
securities laws) to certificates for shares issued upon exercise of this
Warrant:

                  "These securities have not been registered under the
                  Securities Act of 1933, as amended (the "Act"), or any state
                  securities law. They may not be sold, offered for sale,
                  pledged or hypothecated in the absence of a registration
                  statement in effect with respect to the securities under such
                  Act or state securities laws or an opinion of counsel
                  satisfactory to the Company that such registration is not
                  required."

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         6.       NOTICE OF PROPOSED TRANSFERS. The Holder of this Warrant, by
acceptance hereof, agrees to comply in all respects with the provisions of this
Section 6. Prior to any proposed transfer of this Warrant or the Warrant
Shares, unless there is in effect a registration statement under the Securities
Act covering the proposed transfer, the Holder of such securities shall give
written notice to the Company of such Holder's intention to effect such
transfer. Each such notice shall describe the manner and circumstances of the
proposed transfer in sufficient detail, and shall be accompanied by either (i)
a written opinion of legal counsel who shall be reasonably satisfactory to the
Company addressed to the Company and reasonably satisfactory in form and
substance to the Company's counsel, to the effect that the proposed transfer of
the Warrant and/or Warrant Shares may be effected without registration under
the Securities Act, or (ii) a "no action" letter from the Commission to the
effect that the transfer of such securities without registration will not
result in a recommendation by the staff of the Commission that enforcement
action be taken with respect thereto, whereupon the Holder of such securities
shall be entitled to transfer such securities in accordance with the terms of
the notice delivered by the Holder to the Company. Each new certificate
evidencing the Warrant and/or Warrant Shares so transferred shall bear the
appropriate restrictive legends set forth in Section 5(f) above, except that
such certificate shall not bear such restrictive legend, if, in the opinion of
counsel for the Company, such legend is not required in order to establish or
assist in compliance with any provisions of the Securities Act or any
applicable state securities laws.

         7.       LOSS, ETC. OF WARRANT. Upon receipt of evidence satisfactory
to the Company of the loss, theft, destruction or mutilation of this Warrant,
and of indemnity reasonably satisfactory to the Company, if lost, stolen or
destroyed, and upon surrender and cancellation of this Warrant, if mutilated,
the Company shall execute and deliver to the Holder a new Warrant of like date,
tenor and denomination.

         8.       WARRANT HOLDER NOT STOCKHOLDER. This Warrant does not confer
upon the Holder any right to vote on or consent to or receive notice as a
stockholder of the Company, as such, in respect of any matters whatsoever, nor
any other rights or liabilities as a stockholder, prior to the exercise hereof;
this Warrant does, however, require certain notices to the Holder as set forth
herein.

         9.       COMMUNICATION. No notice or other communication under this
Warrant shall be effective unless, but any notice or other communication shall
be effective and shall be deemed to have been given if, the same is in writing
and is mailed by overnight courier service, or by first-class mail, postage
prepaid, addressed to:

                  (a)      the Company at 3401 West End Avenue, Suite 760,
Nashville, Tennessee 37203, Attn: Chief Executive Officer or such other address
as the Company has designated in writing to the Holder, or

                  (b)      the Holder at such address as the Holder has
designated in writing to the Company.

         10.      HEADINGS. The headings of this Warrant have been inserted as
a matter of convenience and shall not affect the construction hereof.

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         11.      APPLICABLE LAW. The terms and conditions of this Warrant
shall be governed by and construed in accordance with the law of the State of
Delaware.

         12.      AMENDMENT, WAIVER, ETC. Except as expressly provided herein,
neither this Warrant nor any term hereof may be amended, waived, discharged or
terminated other than by a written instrument signed by the party against whom
enforcement of any such amendment, waiver, discharge or termination is sought;
provided, however, that any provisions hereof may be amended, waived,
discharged or terminated upon the written consent of the Company and the
Holder.

             (The remainder of this page intentionally left blank)

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         IN WITNESS WHEREOF, the Company has caused this Warrant to be signed
by its Chief Executive Officer and President this 28th day of March, 2002.

                                    SYMBION, INC.

                                    By:
                                       ----------------------------------------
                                       Kenneth C. Mitchell,
                                       VicePresident

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                              SUBSCRIPTION (CASH)

         The undersigned, ___________________, pursuant to the provisions of
the foregoing Warrant, hereby agrees to subscribe for and purchase
____________________ shares of the Common Stock, no par value per share, of
Symbion, Inc. covered by said Warrant, and makes payment therefor in full at
the price per share provided by said Warrant.

Dated:                              Signature:
      -----------------                       ---------------------------------

                                    Address:
                                            -----------------------------------

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                               CASHLESS EXERCISE

         The undersigned ___________________, pursuant to the provisions of the
foregoing Warrant, hereby elects to exchange its Warrant for
___________________ shares of Common Stock, no par value per share, of Symbion,
Inc. pursuant to the Cashless Exercise provisions of the Warrant.

Dated:                              Signature:
      -----------------                       ---------------------------------

                                    Address:
                                            -----------------------------------

                                      10<PAGE>
                                                                    EXHIBIT 4.13

                          DIRECTOR NOMINATION AGREEMENT

         THIS DIRECTOR NOMINATION AGREEMENT (this "Agreement") is made and
entered into as of April 1, 2002, by and among Symbion, Inc., a Tennessee
corporation (the "Company"), on the one hand, and J.H. Whitney III, L.P., a
Delaware limited partnership ("JHW III"), J.H. Whitney IV, L.P., a Delaware
limited partnership ("JHW IV"), and Whitney Strategic Partners III, L.P., a
Delaware limited partnership ("WSP" and together with JHW III and JHW IV, the
"Whitney Shareholders"), on the other hand.

                                    RECITALS:

         WHEREAS, the Company, Symbion Acquisition Sub, Inc., a Delaware
corporation ("Symbion Sub"), and Physicians Surgical Care, Inc., a Delaware
corporation ("PSC"), are parties to that certain Agreement and Plan of Merger,
dated as of March 7, 2002 (the "Merger Agreement"), which provides, among other
things, for Symbion Sub to merge with and into PSC and for PSC to become a
wholly owned subsidiary of the Company (the "Merger");

         WHEREAS, it is a condition to PSC's obligations under the Merger
Agreement that the Company provide the Whitney Shareholders with the right to
designate directors to the Board of Directors of the Company in the manner set
forth herein; and

         WHEREAS, as a condition to the willingness of PSC to enter into the
Merger Agreement, PSC has required that the Company agree, and in order to
induce the Whitney Shareholders to approve the Merger Agreement, the Company has
agreed to enter into this Agreement.

         NOW, THEREFORE, in consideration of the foregoing and the respective
covenants and agreements contained herein, the sufficiency of which is hereby
acknowledged, the parties hereby agree and consent to the following:

         1. Right of Whitney to Designate Board Members. Commencing on the date
hereof and continuing until the Termination Date (as hereinafter defined), the
Company (or its Board of Directors or a committee thereof) shall nominate and
recommend to its shareholders, and use its best efforts to elect, all of the
Company's candidates for the Board of Directors of the Company (the "Board of
Directors") at each annual meeting of the shareholders of the Company, or at any
meeting of the shareholders, at which members of the Board of Directors are to
be elected, and at every adjournment or postponement thereof, which such
candidates for the Board of Directors shall include two (2) individuals
designated by the Whitney Shareholders, acting through Whitney & Co. ("Whitney")
or its written designee (each a "Whitney Director" and collectively, the
"Whitney Directors"); provided, that at any such election, the Company shall
have no such obligation if there are already two (2) Whitney Directors on the
Board of Directors whose terms do not expire at such annual or other
shareholders' meeting; provided, further, that upon any mandatory conversion of
the Series A Convertible Preferred Stock, par value $.01 per share, of the
Company ("Series A Preferred Stock") and the Series B Convertible Preferred
Stock, par value $.01 per share, of the Company ("Series B Preferred Stock")
pursuant to Section 7(B)(5)(b) of the Amended and Restated Charter of the
Company as filed with the Secretary of State of the State of Tennessee on April
1, 2002 (the "Charter") and the payment of the

<PAGE>

Series A Redemption Payment and the Series B Redemption Payment (each as defined
in the Charter), the number of directors to be designated by the Whitney
Shareholders pursuant to this section shall be decreased from two (2)
individuals to one (1) individual; provided, further, that any designee not
employed by Whitney shall be subject to the Company's prior approval.

        2. Vacancy. If at any time during the term of this Agreement, a vacancy
is created on the Board of Directors by reason of incapacity, death, removal or
resignation of a Whitney Director, then the Whitney Shareholders, acting through
Whitney, shall designate an individual whom the Company shall cause to be
elected or designated to fill such vacancy.

        3. Resignation of Directors. If requested by the Company, each Whitney
Director will resign from the Board of Directors if the Company is no longer
required to provide a Board seat for such designee pursuant to the terms hereof.
The Company's obligation to nominate and recommend each Whitney Director is
conditioned upon each director's execution and delivery to the Company of a
written agreement to be bound by the terms of this Section 3.

        4. Termination. This Agreement shall terminate (the "Termination Date")
in its entirety upon the later to occur of (i) the second anniversary of the
effective time of the Merger or (ii) the first anniversary of the closing of an
initial public offering (the "IPO") pursuant to an effective registration
statement under the Securities Act of 1933, as amended, covering the offer and
sale of the common stock of the Company and providing for the payment of the
Series A Redemption Payment and the Series B Redemption Payment to the holders
of the Series A Preferred Stock of the Company and the Series B Preferred Stock
of the Company respectively (as provided in the Charter); provided, however,
that if on the first anniversary of the IPO, the Whitney Shareholders or any of
their affiliates (as defined in Rule 12b-2 under the Securities Exchange Act of
1934, as amended, and the rules and regulations promulgated thereunder)
beneficially own in the aggregate shares of common stock or other securities of
the Company convertible into or exchangeable for shares of voting capital stock
of the Company that represent (after giving effect to any adjustments assuming
the conversion or exchange of any such securities) at least 10% of the total
number of shares of common stock outstanding as of such first anniversary date,
the term of this Agreement shall automatically extend and it shall terminate
upon the second anniversary of the IPO.

        5. Miscellaneous.

                (a) Specific Performance. The parties hereto hereby declare that
        it is impossible to measure in money the damages which will accrue to a
        party hereto by reason of a failure to perform any of the obligations
        under this Agreement and agree that the terms of this Agreement shall be
        specifically enforceable. If any party hereto institutes any action or
        proceeding to specifically enforce the provisions hereof, any person
        against whom such action or proceeding is brought hereby waives the
        claim or defense therein that such party has an adequate remedy at law,
        and such person shall not offer in any such action or proceeding the
        claim or defense that such remedy at law exists.

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<PAGE>

                (B) GOVERNING LAW. THIS AGREEMENT, AND THE RIGHTS OF THE PARTIES
        HERETO, SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS
        OF THE STATE OF DELAWARE WITHOUT GIVING EFFECT TO THE PROVISIONS THEREOF
        RELATING TO CONFLICTS OF LAW.

                (c) Amendment. This Agreement may be amended and any term hereof
        may be waived only by an instrument in writing signed by (i) the Company
        and (ii) each of the Whitney Shareholders.

                (d) Severability. If any term or other provision of this
        Agreement is held to be invalid or illegal or otherwise incapable of
        being enforced by any law or public policy, all other terms and
        provisions of this Agreement shall nevertheless remain in full force and
        effect so long as the economic or legal substance of the transactions
        contemplated hereby is not affected in any manner materially adverse to
        any party. Upon such determination that any term or other provision is
        invalid, illegal or incapable of being enforced, the parties hereto
        shall negotiate in good faith to modify this Agreement so as to effect
        the original intent of the parties as closely as possible in an
        acceptable manner in order that the transactions contemplated hereby are
        consummated as originally contemplated to the greatest extent possible.

                (e) Waivers. No waivers of any breach of this Agreement extended
        by any party hereto to any other party shall be construed as a waiver of
        any rights or remedies of any other party hereto or with respect to any
        subsequent breach.

                (f) Attorneys' Fees. In the event that any suit or action is
        instituted to enforce any provision in this Agreement, the prevailing
        party shall be entitled to all costs and expenses of maintaining such
        suit or action, including reasonable attorneys' fees.

                (g) Counterparts. This Agreement may be executed in one or more
        counterparts, each of which will be deemed an original but all of which
        together shall constitute one and the same agreement.

                (h) Entire Agreement; Assignment. This Agreement constitutes the
        entire agreement among the parties hereto with respect to the matters
        set forth herein, and it supersedes all prior oral or written
        agreements, commitments or understandings with respect to the matters
        provided for herein. This Agreement shall not be assigned by operation
        of law or otherwise.

                [THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK]

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

COMPANY:

SYMBION, INC.

By:  /s/ Richard E. Francis, Jr.
    ----------------------------------------
Name:   Richard E. Francis, Jr.
       -------------------------------------
Title:   President and CEO
        ------------------------------------

WHITNEY SHAREHOLDERS:

J.H. WHITNEY III, L.P.

By:      J.H. Whitney Equity Partners III, L.L.C.,
         its General Partner

         By:   /s/ Daniel J. O'Brien
              ---------------------------------------
                  Name:   Daniel J. O'Brien
                         ----------------------------
                  Title:   Managing Partner
                          ---------------------------

J.H. WHITNEY IV, L.P.

By:      J.H. Whitney Equity Partners IV, L.L.C.,
         its General Partner

         By:  /s/ Daniel J. O'Brien
             ----------------------------------------
                  Name:   Daniel J. O'Brien
                         ----------------------------
                  Title:   Managing Partner
                          ---------------------------

WHITNEY STRATEGIC PARTNERS III, L.P.

By:      J. H. Whitney Equity Partners III, L.L.C.,
         its General Partner

         By:   /s/ Daniel J. O'Brien
              ---------------------------------------
                  Name:  Daniel J. O'Brien
                        -----------------------------
                  Title:  Managing Partner
                         ----------------------------

                                       4

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