Document:

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                                                                    EXHIBIT 10.8

                           IMPAC MEDICAL SYSTEMS, INC.

                        2002 EMPLOYEE STOCK PURCHASE PLAN

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                               TABLE OF CONTENTS

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                                                                              Page
<S>                                                                             <C>
SECTION 1.    PURPOSE ........................................................  1

SECTION 2.    DEFINITIONS ....................................................  1

          (a)      "1934 Act" ................................................  1
          (b)      "Board" ...................................................  1
          (c)      "Code" ....................................................  1
          (d)      "Committee" ...............................................  1
          (e)      "Common Stock" ............................................  1
          (f)      "Company" .................................................  1
          (g)      "Compensation" ............................................  1
          (h)      "Eligible Employee" .......................................  1
          (i)      "Employee" ................................................  2
          (j)      "Employer" or "Employers" .................................  2
          (k)      "Enrollment Date" .........................................  2
          (l)      "Grant Date" ..............................................  2
          (m)      "Initial Public Offering Date" ............................  2
          (n)      "Parent" ..................................................  2
          (o)      "Participant" .............................................  2
          (p)      "Plan" ....................................................  2
          (q)      "Purchase Date" ...........................................  2
          (r)      "Subsidiary" ..............................................  2

SECTION 3.    SHARES SUBJECT TO THE PLAN .....................................  2

          (a)      Number Available. .........................................  2
          (b)      Adjustments. ..............................................  3

SECTION 4.    ENROLLMENT .....................................................  3

          (a)      Participation. ............................................  3
          (b)      Payroll Withholding. ......................................  3

SECTION 5.    OPTIONS TO PURCHASE COMMON STOCK ...............................  4

          (a)      Grant of Option. ..........................................  4
          (b)      Duration of Option. .......................................  4
          (c)      Number of Shares Subject to Option. .......................  4
          (d)      Other Terms and Conditions. ...............................  4

SECTION 6.    PURCHASE OF SHARES .............................................  4

          (a)      Exercise of Option. .......................................  4
          (b)      Delivery of Shares. .......................................  5
          (c)      Exhaustion of Shares. .....................................  5

SECTION 7.    WITHDRAWAL .....................................................  5

SECTION 8.    CESSATION OF PARTICIPATION .....................................  5
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                               TABLE OF CONTENTS
                                   (continued)

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<S>                                                                             <C>
SECTION 9.     DESIGNATION OF BENEFICIARY ...................................   6

           (a)      Designation .............................................   6
           (b)      Changes .................................................   6
           (c)      Failed Designations .....................................   6

SECTION 10.    ADMINISTRATION ...............................................   6

           (a)      Plan Administrator ......................................   6
           (b)      Actions by Committee ....................................   6
           (c)      Powers of Committee .....................................   6
           (d)      Decisions of Committee ..................................   7
           (e)      Administrative Expenses .................................   7
           (f)      Eligibility to Participate ..............................   7
           (g)      Indemnification. ........................................   8

SECTION 11.    AMENDMENT, TERMINATION, AND DURATION .........................   8

           (a)      Amendment, Suspension, or Termination ...................   8
           (b)      Duration of the Plan ....................................   8

SECTION 12.    GENERAL PROVISIONS ...........................................   8

           (a)      Participation by Subsidiaries ...........................   8
           (b)      Inalienability ..........................................   8
           (c)      Severability ............................................   8
           (d)      Requirements of Law .....................................   9
           (e)      Compliance with Rule 16b-3 ..............................   9
           (f)      No Enlargement of Employment Rights .....................   9
           (g)      Apportionment of Costs and Duties .......................   9
           (h)      Construction and Applicable Law .........................   9
           (i)      Captions ................................................   9

SECTION 13.    EXECUTION ....................................................  10
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                                      -II-

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                           IMPAC MEDICAL SYSTEMS, INC.
                        2002 EMPLOYEE STOCK PURCHASE PLAN

SECTION 1. PURPOSE

         IMPAC Medical Systems, Inc. hereby establishes the IMPAC Medical
         Systems, Inc. 2002 Employee Stock Purchase Plan, effective as of the
         Initial Public Offering Date, in order to provide eligible employees
         with the opportunity to purchase Common Stock through payroll
         deductions. The Plan is intended to qualify as an employee stock
         purchase plan under section 423(b) of the Code.

SECTION 2. DEFINITIONS

         (a) "1934 Act" means the Securities Exchange Act of 1934, as amended.
         Reference to a specific section of the 1934 Act or regulation
         thereunder shall include such section or regulation, any valid
         regulation promulgated under such section, and any comparable provision
         of any future legislation or regulation amending, supplementing or
         superseding such section or regulation.

         (b) "Board" means the Board of Directors of the Company.

         (c) "Code" means the Internal Revenue Code of 1986, as amended.
         Reference to a specific section of the Code or regulation thereunder
         shall include such section or regulation, any valid regulation
         promulgated under such section, and any comparable provision of any
         future legislation or regulation amending, supplementing or superseding
         such section or regulation.

         (d) "Committee" shall mean the committee appointed by the Board to
         administer the Plan. Any member of the Committee may resign at any time
         by notice in writing mailed or delivered to the Secretary of the
         Company. As of the effective date of the Plan, the Plan shall be
         administered by the Compensation Committee of the Board.

         (e) "Common Stock" means the common stock of the Company.

         (f) "Company" means IMPAC Medical Systems, Inc., a Delaware
         corporation.

         (g) "Compensation" means a Participant's regular wages. The Committee,
         in its discretion, may (on a uniform and nondiscriminatory basis)
         establish a different definition of Compensation prior to an Enrollment
         Date for all options to be granted on such Enrollment Date.

         (h) "Eligible Employee" means every Employee of an Employer, except (i)
         any Employee who immediately after the grant of an option under the
         Plan, would own stock and/or hold outstanding options to purchase stock
         possessing five percent (5%) or more of the total combined voting power
         or value of all classes of stock of the Company or of any Subsidiary or
         Parent of the Company (including stock attributed to such Employee
         pursuant to section 424(d) of the Code), or (ii) as provided in the
         following sentence.

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         The Committee, in its discretion, from time to time may, prior to an
         Enrollment Date for all options to be granted on such Enrollment Date,
         determine (on a uniform and nondiscriminatory basis) that an Employee
         shall not be an Eligible Employee if he or she: (A) has not completed
         at least two years of service since his or her last hire date (or such
         lesser period of time as may be determined by the Committee in its
         discretion), (B) customarily works not more than 20 hours per week (or
         such lesser period of time as may be determined by the Committee in its
         discretion), or (C) customarily works not more than 5 months per
         calendar year (or such lesser period of time as may be determined by
         the Committee in its discretion).

         (i) "Employee" means an individual who is a common-law employee of any
         Employer, whether such employee is so employed at the time the Plan is
         adopted or becomes so employed subsequent to the adoption of the Plan.

         (j) "Employer" or "Employers" means any one or all of the Company, and
         those Subsidiaries or Parent which, with the consent of the Board, have
         adopted the Plan.

         (k) "Enrollment Date" means such dates as may be determined by the
         Committee (in its discretion and on a uniform and nondiscriminatory
         basis) from time to time.

         (l) "Grant Date" means any date on which a Participant is granted an
         option under the Plan.

         (m) "Initial Public Offering Date" means the date of the final
         prospectus for the initial public offering of the Common Stock.

         (n) "Parent" means a "parent corporation" whether now or hereafter
         existing, as defined in section 424(e) of the Code.

         (o) "Participant" means an Eligible Employee who (i) has become a
         Participant in the Plan pursuant to Section 4(a) and (ii) has not
         ceased to be a Participant pursuant to Section 8 or Section 9.

         (p) "Plan" means the IMPAC Medical Systems, Inc. 2002 Employee Stock
         Purchase Plan, as set forth in this instrument and as hereafter amended
         from time to time.

         (q) "Purchase Date" means such dates as may be determined by the
         Committee (in its discretion and on a uniform and nondiscriminatory
         basis) from time to time prior to an Enrollment Date for all options to
         be granted on such Enrollment Date.

         (r) "Subsidiary" means a "subsidiary corporation" whether now or
         hereafter existing, as defined in section 424(f) of the Code.

SECTION 3. SHARES SUBJECT TO THE PLAN

         (a) Number Available. A maximum of 750,000 shares of Common Stock shall
             ----------------
         be available for issuance pursuant to the Plan. Beginning with the
         first fiscal year of the Company beginning after the effective date of
         the Plan, on the first day of each fiscal

                                                                               2

<PAGE>

         year of the Company, Shares will be added to the Plan equal to the
         lesser of (i) 3% of the outstanding Shares on the last day of the prior
         fiscal year, or (ii) such lesser amount as determined by the Board.
         Shares sold under the Plan may be newly issued shares or treasury
         shares.

         (b) Adjustments. In the event of any reorganization, recapitalization,
             -----------
         stock split, reverse stock split, stock dividend, combination of
         shares, merger, consolidation, offering of rights or other similar
         change in the capital structure of the Company, the Board may make such
         adjustment, if any, as it deems appropriate in the number, kind and
         purchase price of the shares available for purchase under the Plan and
         in the maximum number of shares subject to any option under the Plan.
         Notwithstanding the foregoing, no adjustment shall be made with respect
         to any stock split occurring prior to the Initial Public Offering Date.

SECTION 4. ENROLLMENT

         (a) Participation. Each Eligible Employee may elect to become a
             -------------
         Participant by enrolling or re-enrolling in the Plan effective as of
         any Enrollment Date. In order to enroll, an Eligible Employee must
         complete, sign and submit to the Company an enrollment form in such
         form, manner and by such deadline as may be specified by the Committee
         from time to time (in its discretion and on a nondiscriminatory basis).
         Any Participant whose option expires and who has not withdrawn from the
         Plan automatically will be re-enrolled in the Plan on the Enrollment
         Date immediately following the Purchase Date on which his or her option
         expires. Any Participant whose option has not expired and who has not
         withdrawn from the Plan automatically will be deemed to be un-enrolled
         from the Participant's current option and be enrolled as of a
         subsequent Enrollment Date if the price per Share on such subsequent
         Enrollment Date is lower than the price per Share on the Enrollment
         Date relating to the Participant's current option.

         (b) Payroll Withholding. On his or her enrollment form, each
             -------------------
         Participant must elect to make Plan contributions via payroll
         withholding from his or her Compensation. Pursuant to such procedures
         as the Committee may specify from time to time, a Participant may elect
         to have withholding equal to a whole percentage from 1% to 10% (or such
         lesser, or greater, percentage that the Committee may establish from
         time to time for all options to be granted on any Enrollment Date). A
         Participant may elect to increase or decrease his or her rate of
         payroll withholding by submitting a new enrollment form in accordance
         with such procedures (including, but not limited to, limitations on the
         frequency of such changes) as may be established by the Committee from
         time to time. A Participant may stop his or her payroll withholding by
         submitting a new enrollment form in accordance with such procedures as
         may be established by the Committee from time to time. In order to be
         effective as of a specific date, an enrollment form must be received by
         the Company no later than the deadline specified by the Committee, in
         its discretion and on a nondiscriminatory basis, from time to time. Any
         Participant who is automatically re-enrolled in the Plan will be deemed
         to have elected to continue his or her contributions at the percentage
         last elected by the Participant.

                                                                               3

<PAGE>

SECTION 5.  OPTIONS TO PURCHASE COMMON STOCK

     (a)    Grant of Option. On each Enrollment Date on which the Participant
            ---------------
     enrolls or re-enrolls in the Plan, he or she shall be granted an option to
     purchase shares of Common Stock.

     (b)    Duration of Option. Each option granted under the Plan shall expire
            ------------------
     upon the conclusion of the option's offering period which will end on the
     earliest to occur of (i) the completion of the purchase of shares on the
     last Purchase Date occurring within 27 months of the Grant Date of such
     option, (ii) such shorter option period as may be established by the
     Committee from time to time prior to an Enrollment Date for all options to
     be granted on such Enrollment Date, or (iii) the date on which the
     Participant ceases to be such for any reason. Until otherwise determined by
     the Committee for all options to be granted on an Enrollment Date, the
     period referred to in clause (ii) in the preceding sentence shall mean the
     period from the applicable Enrollment Date through the last business day
     prior to the immediately following Enrollment Date.

     (c)    Number of Shares Subject to Option. The number of shares available
            ----------------------------------
     for purchase by each Participant under the option will be established by
     the Committee from time to time prior to an Enrollment Date for all options
     to be granted on such Enrollment Date.

     (d)    Other Terms and Conditions.  Each option shall be subject to the
            --------------------------
     following additional terms and conditions:

                    (1)   payment for shares purchased under the option shall be
            made only through payroll withholding under Section 4(b);

                    (2)   purchase of shares upon exercise of the option will be
            accomplished only in accordance with Section 6(b);

                    (3)   the price per share under the option will be
            determined as provided in Section 6(a); and

                    (4)   the option in all respects shall be subject to such
            other terms and conditions (applied on a uniform and
            nondiscriminatory basis), as the Committee shall determine from time
            to time in its discretion.

SECTION 6.  PURCHASE OF SHARES

     (a)    Exercise of Option. Subject to Section 6(b), on each Purchase Date,
            ------------------
     the funds then credited to each Participant's account shall be used to
     purchase whole shares of Common Stock. Any cash remaining after whole
     shares of Common Stock have been purchased shall be carried forward in the
     Participant's account for the purchase of shares on the next Purchase Date.
     The price per Share of the Shares purchased under any option granted under
     the Plan shall be eighty-five percent (85%) of the lower of:

                                                                               4

<PAGE>

                       (i)   the closing price per Share on the NASDAQ National
             Market on the business day preceding the Grant Date for such
             option; or

                       (ii)  the closing price per Share on the NASDAQ National
             Market on the Purchase Date;

         provided, however, that with respect to any Grant Date under the Plan
         that coincides with the Initial Public Offering Date, the price in
         clause (i) above shall be the price per Share at which shares of Common
         Stock are initially offered for sale to the public by the Company's
         underwriters in such offering.

         (b) Delivery of Shares. As directed by the Committee in its sole
             ------------------
         discretion, shares purchased on any Purchase Date shall be delivered
         directly to the Participant or to a custodian or broker (if any)
         designated by the Committee to hold shares for the benefit of the
         Participants. As determined by the Committee from time to time, such
         shares shall be delivered as physical certificates or by means of a
         book entry system.

         (c) Exhaustion of Shares. If at any time the shares available under the
             --------------------
         Plan are over-enrolled, enrollments shall be reduced proportionately to
         eliminate the over-enrollment. Such reduction method shall be "bottom
         up," with the result that all option exercises for one share shall be
         satisfied first, followed by all exercises for two shares, and so on,
         until all available shares have been exhausted. Any funds that, due to
         over-enrollment, cannot be applied to the purchase of whole shares
         shall be refunded to the Participants (without interest thereon).

SECTION 7.   WITHDRAWAL

         A Participant may withdraw from the Plan by submitting a completed
         enrollment form to the Company. A withdrawal will be effective only if
         it is received by the Company by the deadline specified by the
         Committee (in its discretion and on a uniform and nondiscriminatory
         basis) from time to time. When a withdrawal becomes effective, the
         Participant's payroll contributions shall cease and all amounts then
         credited to the Participant's account shall be distributed to him or
         her (without interest thereon).

SECTION 8.   CESSATION OF PARTICIPATION

         A Participant shall cease to be a Participant immediately upon the
         cessation of his or her status as an Eligible Employee (for example,
         because of his or her termination of employment from all Employers for
         any reason). As soon as practicable after such cessation, the
         Participant's payroll contributions shall cease and all amounts then
         credited to the Participant's account shall be distributed to him or
         her (without interest thereon). If a Participant is on a
         Company-approved leave of absence, his or her participation in the Plan
         shall continue for so long as he or she remains an Eligible Employee
         and has not withdrawn from the Plan pursuant to Section 7.

                                                                               5

<PAGE>

SECTION 9.  DESIGNATION OF BENEFICIARY

     (a)    Designation. Each Participant may, pursuant to such uniform and
            -----------
     nondiscriminatory procedures as the Committee may specify from time to
     time, designate one or more Beneficiaries to receive any amounts credited
     to the Participant's account at the time of his or her death.
     Notwithstanding any contrary provision of this Section 9, Sections 9(a) and
     9(b) shall be operative only after (and for so long as) the Committee
     determines (on a uniform and nondiscriminatory basis) to permit the
     designation of Beneficiaries.

     (b)    Changes. A Participant may designate different Beneficiaries (or may
            -------
     revoke a prior Beneficiary designation) at any time by delivering a new
     designation (or revocation of a prior designation) in like manner. Any
     designation or revocation shall be effective only if it is received by the
     Committee. However, when so received, the designation or revocation shall
     be effective as of the date the designation or revocation is executed
     (whether or not the Participant still is living), but without prejudice to
     the Committee on account of any payment made before the change is recorded.
     The last effective designation received by the Committee shall supersede
     all prior designations.

     (c)    Failed Designations.  If a Participant dies without having
            -------------------
     effectively designated a Beneficiary, or if no Beneficiary survives the
     Participant, the Participant's Account shall be payable to his or her
     estate.

SECTION 10.         ADMINISTRATION

     (a)    Plan Administrator. The Plan shall be administered by the Committee.
            ------------------
     The Committee shall have the authority to control and manage the operation
     and administration of the Plan.

     (b)    Actions by Committee. Each decision of a majority of the members of
            --------------------
     the Committee then in office shall constitute the final and binding act of
     the Committee. The Committee may act with or without a meeting being called
     or held and shall keep minutes of all meetings held and a record of all
     actions taken by written consent.

     (c)    Powers of Committee. The Committee shall have all powers and
            -------------------
     discretion necessary or appropriate to supervise the administration of the
     Plan and to control its operation in accordance with its terms, including,
     but not by way of limitation, the following discretionary powers:

                   (i)  To interpret and determine the meaning and validity of
            the provisions of the Plan and the options and to determine any
            question arising under, or in connection with, the administration,
            operation or validity of the Plan or the options;

                   (ii) To determine any and all considerations affecting the
            eligibility of any employee to become a Participant or to remain a
            Participant in the Plan;

                                                                               6

<PAGE>

                     (iii)  To cause an account or accounts to be maintained for
            each Participant;

                     (iv)   To determine the time or times when, and the number
            of shares for which, options shall be granted;

                     (v)    To establish and revise an accounting method or
            formula for the Plan;

                     (vi)   To designate a custodian or broker to receive shares
            purchased under the Plan and to determine the manner and form in
            which shares are to be delivered to the designated custodian or
            broker;

                     (vii)  To determine the status and rights of Participants
            and their Beneficiaries or estates;

                     (viii) To employ such brokers, counsel, agents and
            advisers, and to obtain such broker, legal, clerical and other
            services, as it may deem necessary or appropriate in carrying out
            the provisions of the Plan;

                     (ix)   To establish, from time to time, rules for the
            performance of its powers and duties and for the administration of
            the Plan;

                     (x)    To adopt such procedures and subplans as are
            necessary or appropriate to permit participation in the Plan by
            employees who are foreign nationals or employed outside of the
            United States;

                     (xi)   To delegate to any one or more of its members or to
            any other person, severally or jointly, the authority to perform for
            and on behalf of the Committee one or more of the functions of the
            Committee under the Plan.

     (d)    Decisions of Committee. All actions, interpretations, and decisions
            ----------------------
     of the Committee shall be conclusive and binding on all persons, and shall
     be given the maximum possible deference allowed by law.

     (e)    Administrative Expenses. All expenses incurred in the administration
            -----------------------
     of the Plan by the Committee, or otherwise, including legal fees and
     expenses, shall be paid and borne by the Employers, except any stamp duties
     or transfer taxes applicable to the purchase of shares may be charged to
     the account of each Participant. Any brokerage fees for the purchase of
     shares by a Participant shall be paid by the Company, but fees and taxes
     (including brokerage fees) for the transfer, sale or resale of shares by a
     Participant, or the issuance of physical share certificates, shall be borne
     solely by the Participant.

     (f)    Eligibility to Participate. No member of the Committee who is also
            --------------------------
     an employee of an Employer shall be excluded from participating in the Plan
     if otherwise eligible, but he or she shall not be entitled, as a member of
     the Committee, to act or pass upon any matters pertaining specifically to
     his or her own account under the Plan.

                                                                               7

<PAGE>

     (g)  Indemnification. Each of the Employers shall, and hereby does,
          ---------------
     indemnify and hold harmless the members of the Committee and the Board,
     from and against any and all losses, claims, damages or liabilities
     (including attorneys' fees and amounts paid, with the approval of the
     Board, in settlement of any claim) arising out of or resulting from the
     implementation of a duty, act or decision with respect to the Plan, so long
     as such duty, act or decision does not involve gross negligence or willful
     misconduct on the part of any such individual.

SECTION 11.    AMENDMENT, TERMINATION, AND DURATION

     (a)  Amendment, Suspension, or Termination. The Board, in its sole
          -------------------------------------
     discretion, may amend or terminate the Plan, or any part thereof, at any
     time and for any reason. If the Plan is terminated, the Board, in its
     discretion, may elect to terminate all outstanding options either
     immediately or upon completion of the purchase of shares on the next
     Purchase Date, or may elect to permit options to expire in accordance with
     their terms (and participation to continue through such expiration dates).
     If the options are terminated prior to expiration, all amounts then
     credited to Participants' accounts which have not been used to purchase
     shares shall be returned to the Participants (without interest thereon) as
     soon as administratively practicable.

     (b)  Duration of the Plan. The Plan shall commence on the date specified
          --------------------
     herein, and subject to Section 11(a) (regarding the Board's right to amend
     or terminate the Plan), shall remain until December 31, 2012.

SECTION 12.    GENERAL PROVISIONS

     (a)  Participation by Subsidiaries. One or more Subsidiaries of the Company
          -----------------------------
     may become participating Employers by adopting the Plan and obtaining
     approval for such adoption from the Board. By adopting the Plan, a
     Subsidiary shall be deemed to agree to all of its terms, including (but not
     limited to) the provisions granting exclusive authority (i) to the Board to
     amend the Plan, and (ii) to the Committee to administer and interpret the
     Plan. An Employer may terminate its participation in the Plan at any time.
     The liabilities incurred under the Plan to the Participants employed by
     each Employer shall be solely the liabilities of that Employer, and no
     other Employer shall be liable for benefits accrued by a Participant during
     any period when he or she was not employed by such Employer.

     (b)  Inalienability. In no event may either a Participant, a former
          --------------
     Participant or his or her Beneficiary, spouse or estate sell, transfer,
     anticipate, assign, hypothecate, or otherwise dispose of any right or
     interest under the Plan; and such rights and interests shall not at any
     time be subject to the claims of creditors nor be liable to attachment,
     execution or other legal process. Accordingly, for example, a Participant's
     interest in the Plan is not transferable pursuant to a domestic relations
     order.

     (c)  Severability. In the event any provision of the Plan shall be held
          ------------
     illegal or invalid for any reason, the illegality or invalidity shall not
     affect the remaining parts of the Plan,

                                                                               8

<PAGE>

     and the Plan shall be construed and enforced as if the illegal or invalid
     provision had not been included.

     (d)  Requirements of Law. The granting of options and the issuance of
          -------------------
     shares shall be subject to all applicable laws, rules, and regulations, and
     to such approvals by any governmental agencies or securities exchanges as
     the Committee may determine are necessary or appropriate.

     (e)  Compliance with Rule 16b-3. Any transactions under this Plan with
          --------------------------
     respect to officers (as defined in Rule 16a-1 promulgated under the 1934
     Act) are intended to comply with all applicable conditions of Rule 16b-3.
     To the extent any provision of the Plan or action by the Committee fails to
     so comply, it shall be deemed null and void, to the extent permitted by law
     and deemed advisable by the Committee. Notwithstanding any contrary
     provision of the Plan, if the Committee specifically determines that
     compliance with Rule 16b-3 no longer is required, all references in the
     Plan to Rule 16b-3 shall be null and void.

     (f)  No Enlargement of Employment Rights. Neither the establishment or
          -----------------------------------
     maintenance of the Plan, the granting of options, the purchase of shares,
     nor any action of any Employer or the Committee, shall be held or construed
     to confer upon any individual any right to be continued as an employee of
     the Employer nor, upon dismissal, any right or interest in any specific
     assets of the Employers other than as provided in the Plan. Each Employer
     expressly reserves the right to discharge any employee at any time, with or
     without cause.

     (g)  Apportionment of Costs and Duties. All acts required of the Employers
          ---------------------------------
     under the Plan may be performed by the Company for itself and its
     Subsidiaries, and the costs of the Plan may be equitably apportioned by the
     Committee among the Company and the other Employers. Whenever an Employer
     is permitted or required under the terms of the Plan to do or perform any
     act, matter or thing, it shall be done and performed by any officer or
     employee of the Employers who is thereunto duly authorized by the
     Employers.

     (h)  Construction and Applicable Law. The Plan is intended to qualify as
          -------------------------------
     an "employee stock purchase plan" within the meaning of section 423(b) of
     the Code. Any provision of the Plan which is inconsistent with section
     423(b) of the Code shall, without further act or amendment by the Company
     or the Committee, be reformed to comply with the requirements of section
     423(b) of the Code. The provisions of the Plan shall be construed,
     administered and enforced in accordance with such Section and with the laws
     of the State of California (excluding California's conflict of laws
     provisions).

     (i)  Captions. The captions contained in and the table of contents prefixed
          --------
     to the Plan are inserted only as a matter of convenience, and in no way
     define, limit, enlarge or describe the scope or intent of the Plan nor in
     any way shall affect the construction of any provision of the Plan.

                                                                               9

<PAGE>

SECTION 13.    EXECUTION.

     To record the adoption of the Plan by the Board, the Company has caused its
     duly authorized officer to execute this Plan on behalf of the Company.

                                        IMPAC Medical Systems, Inc.

                                        By _________________________________

                                        Title ______________________________

                                                                              10<PAGE>

                                                               EXHIBIT 10.9
                                                               GRANT NO. _______

                           IMPAC MEDICAL SYSTEMS, INC.

                                 2002 STOCK PLAN

                        INCENTIVE STOCK OPTION AGREEMENT

         IMPAC Medical Systems, Inc. (the "Company"), hereby grants an Option to
purchase shares of its common stock (the "Shares") to the Optionee named below.
The terms and conditions of the Option are set forth in this cover sheet, in the
attachment and in the Company's 2002 Stock Plan (the "Plan").

Date of Option Grant:  __________________, 200__

Name of Optionee:  _________________________________________________

Number of Shares Covered by Option:  ______________

Exercise Price per Share:  $_____.___

Total Exercise Price:  $_____.___

Vesting Start Date:  _____________, 200__

Vesting Schedule:

         Subject to all the terms of the attached Agreement, your right to
purchase Shares under this Option vests as to one-fourth (1/4) of the total
number of Shares covered by this Option, as shown above, on the one-year
anniversary of the Vesting Start Date. Thereafter, the number of Shares which
you may purchase under this Option shall vest at the rate of one-forty-eighth
(1/48) per month on the 1st day of each of the thirty-six (36) months following
the month of the one-year anniversary of the Vesting Start Date. The resulting
aggregate number of vested Shares will be rounded to the nearest whole number.
No additional Shares will vest after your Service has terminated for any reason.

         By signing this cover sheet, you agree to all of the terms and
conditions described in the attached Agreement and in the Plan, a copy of which
is also enclosed.

Optionee:
            ________________________________________________
                                (Signature)

Company:
            ________________________________________________
                                (Signature)

            Title: _________________________________________

Attachment
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                          IMPACT MEDICAL SYSTEMS, INC.

                                 2002 STOCK PLAN

                        INCENTIVE STOCK OPTION AGREEMENT

The Plan and                      The text of the Plan is incorporated in this
Other Agreements                  Agreement by reference. Certain capitalized
                                  terms used in this Agreement are defined in
                                  the Plan.

                                  This Agreement and the Plan constitute
                                  the entire understanding between you
                                  and the Company regarding this Option.
                                  Any prior agreements, commitments or
                                  negotiations concerning this Option are
                                  superseded.

Incentive Stock Option            This Option is intended to be an Incentive
                                  Stock Option under section 422 of the Internal
                                  Revenue Code and will be interpreted
                                  accordingly. If you cease to be an employee of
                                  the Company, a Subsidiary or of a Parent but
                                  continue to provide Service, this Option will
                                  be deemed a Nonstatutory Stock Option on the
                                  90th day after you cease to be an employee. In
                                  addition, to the extent that all or part of
                                  this Option exceeds the $100,000 rule of
                                  section 422(d) of the Code, this Option or the
                                  lesser excess part will be treated as a
                                  Nonstatutory Stock Option.

Vesting                           This Option is only exercisable before it
                                  expires and then only with respect to the
                                  vested portion of the Option. This Option will
                                  vest according to the Vesting Schedule on the
                                  attached cover sheet.

Term                              Your Option will expire in any event at
                                  the close of business at Company
                                  headquarters on the day before the 10th
                                  anniversary of the Date of Option
                                  Grant, as shown on the cover sheet.
                                  Your Option will expire earlier if your
                                  Service terminates, as described below.

Regular Termination               If your Service terminates for any reason,
                                  other than death, Disability or Cause, as
                                  defined below, then your Option will expire at
                                  the close of business at Company headquarters
                                  on the 90th day after your termination date.

Termination for Cause             If your Service is terminated for Cause, as
                                  determined by the Board in its Cause sole
                                  discretion, then you shall immediately forfeit
                                  all rights to your Option and the Option shall
                                  immediately expire. For purposes of this
                                  Agreement, "Cause" shall mean the termination
                                  of your Service due to your commission of any
                                  act of fraud, embezzlement or dishonesty; any
                                  unauthorized use

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                                  or disclosure of confidential information
                                  or trade secrets of the Company (or any
                                  Parent, Subsidiary or Affiliate); or
                                  any other intentional misconduct
                                  adversely affecting the business or
                                  affairs of the Company (or any Parent,
                                  Subsidiary or Affiliate) in a material
                                  manner. This definition shall not
                                  restrict in any way the Company's or
                                  any Parent's, Subsidiary's or
                                  Affiliate's right to discharge you for
                                  any other reason, nor shall this
                                  definition be deemed to be inclusive of
                                  all the acts or omissions which
                                  constitute "cause" for purposes other
                                  than this Agreement.

Death                             If your Service terminates because of
                                  your death, then your Option will
                                  expire at the close of business at
                                  Company headquarters on the date twelve
                                  (12) months after the date of death.
                                  During that twelve (12) month period,
                                  your estate or heirs may exercise the
                                  vested portion of your Option.

Disability                        If your Service terminates because of
                                  your Disability, then your Option will
                                  expire at the close of business at
                                  Company headquarters on the date twelve
                                  (12) months after your termination
                                  date.

Leaves of Absence                 For purposes of this Option, your Service does
                                  not terminate when you go on a bona fide leave
                                  of absence that was approved by the Company in
                                  writing, if the terms of the leave provide for
                                  continued Service crediting, or when continued
                                  Service crediting is required by applicable
                                  law. However, your Service will be treated as
                                  terminating ninety (90) days after you went on
                                  leave, unless your right to return to active
                                  work is guaranteed by law or by a contract.
                                  Your Service terminates in any event when the
                                  approved leave ends unless you immediately
                                  return to active work.

                                  The Company determines which leaves
                                  count for this purpose, and when your
                                  Service terminates for all purposes
                                  under the Plan.

Notice of Exercise                When you wish to exercise this Option, you
                                  must notify the Company by filing the proper
                                  "Notice of Exercise" form at the address given
                                  on the form. Your notice must specify how many
                                  Shares you wish to purchase. Your notice must
                                  also specify how your Shares should be
                                  registered (in your name only or in your and
                                  your spouse's names as community property or
                                  as joint tenants with right of survivorship).
                                  The notice will be effective when it is
                                  received by the Company.

                                  If someone else wants to exercise this
                                  Option after your death,

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<PAGE>

                              that person must prove to the Company's
                              satisfaction that he or she is entitled to do so.

Form of Payment               When you submit your notice of exercise, you must
                              include payment of the Exercise Price for the
                              Shares you are purchasing. Payment may be made
                              in one (or a combination) of the following forms:

                              .  Cash, your personal check, a cashier's check, a
                                 money order or an electronic funds transfer.

                              .  Shares which have already been owned by you for
                                 more than six months and which are surrendered
                                 to the Company. The value of the Shares,
                                 determined as of the effective date of the
                                 Option exercise, will be applied to the
                                 Exercise Price.

                              .  To the extent a public market for the Shares
                                 exists as determined by the Company, by
                                 delivery (on a form prescribed by the Company)
                                 of an irrevocable direction to a securities
                                 broker to sell Shares and to deliver all or
                                 part of the sale proceeds to the Company in
                                 payment of the aggregate Exercise Price.

Withholding Taxes             You will not be allowed to exercise this Option
                              unless you make acceptable arrangements to pay any
                              withholding or other taxes that may be due as a
                              result of the Option exercise or sale of Shares
                              acquired under this Option.

Restrictions on Exercise and  By signing this Agreement, you agree not to
Resale                        exercise this Option or sell any Shares acquired
                              under this Option at a time when applicable laws,
                              regulations or Company or underwriter trading
                              policies prohibit exercise, sale or issuance of
                              Shares.  The Company will not permit you to
                              exercise this Option if the issuance of Shares at
                              that time would violate any law or regulation.
                              The Company shall have the right to designate one
                              or more periods of time, each of which shall not
                              exceed one hundred eighty (180) days in length,
                              during which this Option shall not be exercisable
                              if the Company determines (in its sole discretion)
                              that such limitation on exercise could in any way
                              facilitate a lessening of any restriction on
                              transfer pursuant to the Securities Act or any
                              state securities laws with respect to any issuance
                              of securities by the Company, facilitate the
                              registration or qualification of any securities by
                              the Company under the Securities Act or any state
                              securities laws, or facilitate the perfection of
                              any exemption from the registration or
                              qualification requirements of the Securities Act
                              or any applicable state securities laws for the
                              issuance or transfer of

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                              any securities.  Such limitation on exercise shall
                              not alter the vesting schedule set forth in this
                              Agreement other than to limit the periods during
                              which this Option shall be exercisable.

                              If the sale of Shares under the Plan is not
                              registered under the Securities Act, but an
                              exemption is available which requires an
                              investment or other representation, you shall
                              represent and agree at the time of exercise that
                              the Shares being acquired upon exercise of this
                              Option are being acquired for investment, and not
                              with a view to the sale or distribution thereof,
                              and shall make such other representations as are
                              deemed necessary or appropriate by the Company and
                              its counsel.

Transfer of Option            Prior to your death, only you may exercise this
                              Option. You cannot transfer or assign this Option.
                              For instance, you may not sell this Option or use
                              it as security for a loan. If you attempt to do
                              any of these things, this Option will immediately
                              become invalid. You may, however, dispose of this
                              Option in your will.

                              Regardless of any marital property settlement
                              agreement, the Company is not obligated to honor a
                              notice of exercise from your spouse, nor is the
                              Company obligated to recognize your spouse's
                              interest in your Option in any other way.

Retention Rights              Your Option or this Agreement does not give you
                              the right to be retained by the Company (or any
                              Parent or any Subsidiaries or Affiliates) in
                              any capacity. The Company (or any Parent and any
                              Subsidiaries or Affiliates) reserves the right to
                              terminate your Service at any time and for any
                              reason.

Stockholder Rights            You, or your estate or heirs, have no rights as a
                              stockholder of the Company until a certificate for
                              your Option's Shares has been issued. No
                              adjustments are made for dividends or other rights
                              if the applicable record date occurs before your
                              stock certificate is issued, except as described
                              in the Plan.

Adjustments                   In the event of a stock split, a stock dividend or
                              a similar change in the Company stock, the number
                              of Shares covered by this Option and the exercise
                              price per Share may be adjusted (and rounded down
                              to the nearest whole number) pursuant to the Plan.
                              Your Option shall be subject to the terms of the
                              agreement of merger, liquidation or reorganization
                              in the event the Company is subject to such
                              corporate activity.

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Legends                       All certificates representing the Shares issued
                              upon exercise of this Option shall, where
                              applicable, have endorsed thereon the following
                              legends (or such other legend(s) as may be
                              necessary to comply with applicable state or
                              federal securities laws):

                                "THE SHARES REPRESENTED BY THIS CERTIFICATE ARE
                                SUBJECT TO CERTAIN RESTRICTIONS ON TRANSFER AND
                                OPTIONS TO PURCHASE SUCH SHARES SET FORTH IN AN
                                AGREEMENT BETWEEN THE COMPANY AND THE REGISTERED
                                HOLDER, OR HIS OR HER PREDECESSOR IN INTEREST.
                                A COPY OF SUCH AGREEMENT IS ON FILE AT THE
                                PRINCIPAL OFFICE OF THE COMPANY AND WILL BE
                                FURNISHED UPON WRITTEN REQUEST TO THE SECRETARY
                                OF THE COMPANY BY THE HOLDER OF RECORD OF THE
                                SHARES REPRESENTED BY THIS CERTIFICATE."

                                "THE SHARES REPRESENTED HEREBY HAVE NOT BEEN
                                REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
                                AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR
                                OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE
                                REGISTRATION THEREOF UNDER SUCH ACT OR AN
                                OPINION OF COUNSEL, SATISFACTORY TO THE
                                COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION
                                IS NOT REQUIRED."

Applicable Law                This Agreement will be interpreted and enforced
                              under the laws of the State of California.

        By signing the cover sheet of this Agreement, you agree to all of the
        terms and conditions described above and in the Plan.

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