Document:

EX-10.4(a)

 Exhibit 10.4(a) 

ENTELLUS MEDICAL, INC. 

2015 INCENTIVE AWARD PLAN 

STOCK OPTION GRANT NOTICE 

Entellus Medical, Inc., a Delaware corporation (the “Company”), pursuant to its 2015 Incentive Award Plan (as may be
amended from time to time, the “Plan”), hereby grants to the individual listed below (the “Optionee”), an option to purchase the number of shares of Common Stock, par value $0.001 per share, of the
Company (the “Shares”), set forth below (the “Option”). This Option is subject to all of the terms and conditions set forth herein and in the Stock Option Agreement attached hereto as Exhibit A
(the “Agreement”) and the Plan, each of which is incorporated herein by reference. Unless otherwise defined herein, the terms defined in the Plan shall have the same defined meanings in this Stock Option Grant Notice (the
“Grant Notice”) and the Agreement. 
  

					
	 Optionee:
	 	[                    ]	  	
			
	 Grant Date:
	 	[                    ]	  	
			
	 Vesting Commencement Date:
	 	[                    ]	  	
		
	 Exercise Price per Share:
	 	$[ — ]
/Share                                        
                                    
			
	 Total Number of Shares

Subject to the Option:
	 	[                    ] Shares	  	
			
	 Expiration Date:
	 	[                    ]	  	
			
	 Vesting Schedule:
	 	[                    ]	  	
		
	 Termination:
	 	The Option shall terminate on the Expiration Date set forth above or, if earlier, in accordance with the terms of the Agreement

 Type of
Option:         ̈    Incentive Stock
Option         ̈    Non-Qualified Stock Option 

By his or her signature below, the Optionee agrees to be bound by the terms and conditions of the Plan, the Agreement and this Grant Notice.
The Optionee has reviewed the Agreement, the Plan and this Grant Notice in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Grant Notice and fully understands all provisions of this Grant Notice, the
Agreement and the Plan. The Optionee hereby agrees to accept as binding, conclusive and final all decisions and/or interpretations of the Administrator upon any questions arising under the Plan or relating to the Option. If the Optionee lives in a
community property state and either is married or has a registered domestic partner, his or her spouse has signed the Consent of Spouse attached to this Grant Notice as Exhibit B 

 

									
	ENTELLUS MEDICAL, INC.	 		 	OPTIONEE
					
	By:	 	  
	 		 	By:	 	  

	Print Name:	 	  
	 		 	Print Name:	 	  

	Title:	 	  
	 		 		 	
	Address:	 	  
	 		 	Address:	 	  

		 		 		 	Email:	 	  

 EXHIBIT A 

TO STOCK OPTION GRANT NOTICE 

STOCK OPTION AGREEMENT 

Pursuant to the Stock Option Grant Notice (the “Grant Notice”) to which this Stock Option Agreement
(this “Agreement”) is attached, Entellus Medical, Inc., a Delaware corporation (the “Company”), has granted to the Optionee an option (the “Option”) under the Company’s
2015 Incentive Award Plan (as amended from time to time, the “Plan”) to purchase the number of Shares indicated in the Grant Notice.  

ARTICLE I. 
 GENERAL

 1.1 Incorporation of Terms of Plan. The Option is subject to the terms and conditions of the Plan, which are incorporated
herein by reference. In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan shall control. 
 1.2
Defined Terms. Wherever the following terms are used in this Agreement they shall have the meanings specified below, unless the context clearly indicates otherwise. Capitalized terms not specifically defined herein shall have the meanings
specified in the Plan and the Grant Notice. 
 (a) “Retirement” shall mean a Separation from Service due to a normal
or approved early termination of employment or service pursuant to and in accordance with an applicable retirement/pension plan, program, policy or practice of the Company or an Affiliate, as determined by the Company or the Affiliate in its sole
discretion. 
 (b) “Separation from Service” shall mean the Optionee’s “separation from service” from
the Company or any Affiliate within the meaning of Section 409A(a)(2)(A)(i) of the Code. 
 ARTICLE II. 

GRANT OF OPTION 
 2.1
Grant of Option. In consideration of the Optionee’s past and/or continued employment with or service to the Company or any Affiliate and for other good and valuable consideration, effective as of the Grant Date set forth in the Grant
Notice (the “Grant Date”), the Company irrevocably grants to the Optionee the Option to purchase any part or all of the aggregate number of Shares set forth in the Grant Notice, upon the terms and conditions set forth in the
Plan and this Agreement. Unless designated as a Non-Qualified Stock Option in the Grant Notice, the Option shall be an Incentive Stock Option to the maximum extent permitted by law. 

2.2 Exercise Price. The exercise price of the Shares subject to the Option shall be as set forth in the Grant Notice, without
commission or other charge; provided, however, that the exercise price per share of the Shares subject to the Option shall not be less than 100% of the Fair Market Value of a Share on the Grant Date. Notwithstanding the foregoing, if
this Option is an Incentive Stock Option and the Optionee is a Greater Than 10% Stockholder as of the Grant Date, the exercise price per share of the Shares subject to the Option shall not be less than 110% of the Fair Market Value of a Share on the
Grant Date. 

  
 A-1 

 2.3 Consideration to the Company. In consideration of the grant of the Option by the
Company, the Optionee agrees to render faithful and efficient services to the Company or any Affiliate. Nothing in the Plan or this Agreement shall confer upon the Optionee any right to continue in the employ or service of the Company or any
Affiliate or shall interfere with or restrict in any way the rights of the Company and its Affiliates, which rights are hereby expressly reserved, to discharge or terminate the services of the Optionee at any time for any reason whatsoever, with or
without cause, except to the extent expressly provided otherwise in a written agreement between the Company or an Affiliate and the Optionee. 

ARTICLE III. 
 PERIOD OF
EXERCISABILITY 
 3.1 Commencement of Exercisability. 

(a) Subject to Sections 3.1(b), 3.2, 3.3, 5.8 and 5.9 hereof, the Option shall become vested and exercisable in such amounts and at such times
as are set forth in the Grant Notice. 
 (b) No portion of the Option which has not become vested and exercisable as of the date of the
Optionee’s Termination of Service shall thereafter become vested and exercisable, except as may be otherwise provided by the Administrator or as set forth in a written agreement between the Company and the Optionee. 

3.2 Duration of Exercisability. Any installments provided for in the vesting schedule set forth in the Grant Notice are cumulative.
Each such installment which becomes vested and exercisable pursuant to the vesting schedule set forth in the Grant Notice shall remain vested and exercisable until it becomes unexercisable under Section 3.3 hereof. 

3.3 Expiration of Option. The Option may not be exercised to any extent by anyone after the first to occur of the following events:

 (a) The Expiration Date set forth in the Grant Notice; 

(b) If this Option is designated as an Incentive Stock Option and the Optionee is a Greater Than 10% Stockholder as of the Grant Date, the
expiration of five (5) years from the Grant Date; 
 (c) The date that is three (3) months from the date of the Optionee’s
Termination of Service by the Company without cause or by the Optionee for any reason (other than due to Retirement, death or disability); 

(d) The expiration of one (1) year from the date of the Optionee’s Termination of Service by reason of the Optionee’s death or
disability; 
 (e) The expiration of six (6) months from the date of the Optionee’s Termination of Service by reason of the
Optionee’s Retirement; or 
 (f) The start of business on the date of the Optionee’s Termination of Service by the Company for
cause. 

  
 A-2 

 The Optionee acknowledges that an Incentive Stock Option exercised more than three
(3) months after the Optionee’s termination of employment, other than by reason of death or disability, will be taxed as a Non-Qualified Stock Option. 

3.4 Special Tax Consequences. The Optionee acknowledges that, to the extent that the aggregate Fair Market Value (determined as of the
time the Option is granted) of all Shares with respect to which “incentive stock options” (within the meaning of Section 422 of the Code, but without regard to Section 422(d) of the Code), including the Option, are exercisable
for the first time by the Optionee in any calendar year exceeds $100,000, the Option and such other options shall be Non-Qualified Stock Options to the extent necessary to comply with the limitations imposed by Section 422(d) of the Code. The
Optionee further acknowledges that the rule set forth in the preceding sentence shall be applied by taking the Option and other “incentive stock options” into account in the order in which they were granted, as determined under
Section 422(d) of the Code and the Treasury Regulations thereunder. 
 ARTICLE IV. 

EXERCISE OF OPTION 
 4.1
Person Eligible to Exercise. Except as provided in Section 5.2 hereof, during the lifetime of the Optionee, only the Optionee may exercise the Option or any portion thereof. After the death of the Optionee, any exercisable portion of the
Option may, prior to the time when the Option becomes unexercisable under Section 3.3 hereof, be exercised by the deceased Optionee’s beneficiary or by any person empowered to do so under the deceased Optionee’s will or under the
then-applicable laws of descent and distribution, subject to Section 11.3(c) of the Plan. 
 4.2 Partial Exercise. Any
exercisable portion of the Option or the entire Option, if then wholly exercisable, may be exercised in whole or in part at any time prior to the time when the Option or portion thereof becomes unexercisable under Section 3.3 hereof. However,
the Option shall not be exercisable with respect to fractional shares. 
 4.3 Manner of Exercise. The Option, or any exercisable
portion thereof, may be exercised solely by delivery to the stock administrator of the Company (or any other person or entity designated by the Company) of all of the following prior to the time when the Option or such portion thereof becomes
unexercisable under Section 3.3 hereof: 
 (a) A written or electronic notice complying with the applicable rules established by the
Administrator stating that the Option, or a portion thereof, is exercised. The notice shall be signed by the Optionee or other person then-entitled to exercise the Option or such portion of the Option; 

(b) Full payment of the exercise price and applicable withholding taxes for the Shares with respect to which the Option, or portion thereof,
is exercised, in a manner permitted by Section 4.4 hereof; 
 (c) Any other representations or documents as may be required in the
Administrator’s sole discretion to effect compliance with all applicable provisions of the Securities Act, the Exchange Act, any other federal, state or foreign securities laws or regulations, the rules of any securities exchange, national
market system or automated quotation system on which the Shares are listed, quoted or traded or any other applicable law; and 

  
 A-3 

 (d) In the event the Option or portion thereof shall be exercised pursuant to Section 4.1
hereof by any person or persons other than the Optionee, appropriate proof of the right of such person or persons to exercise the Option (as determined by the Administrator in its sole discretion). 

Notwithstanding any of the foregoing, the Company shall have the right to specify all conditions of the manner of exercise, which conditions may vary by
country and which may be subject to change from time to time. 
 4.4 Method of Payment. Payment of the exercise price shall be by any
of the following, or a combination thereof, at the election of the Optionee: 
 (a) Cash; 

(b) Check; 
 (c) Delivery of a
written or electronic notice that the Optionee has placed a market sell order with a broker with respect to Shares then issuable upon exercise of the Option, and that the broker has been directed to pay a sufficient portion of the net proceeds of
the sale to the Company in satisfaction of the aggregate exercise price; provided, that payment of such proceeds is then made to the Company upon settlement of such sale; 

(d) With the consent of the Administrator, surrender of other Shares which have been held by the Optionee for such period of time as may be
required by the Administrator in order to avoid adverse accounting consequences and having a Fair Market Value on the date of surrender equal to the aggregate exercise price of the Shares with respect to which the Option or portion thereof is being
exercised; 
 (e) With the consent of the Administrator, surrendered Shares issuable upon the exercise of the Option having a Fair Market
Value on the date of exercise equal to the aggregate exercise price of the Shares with respect to which the Option or portion thereof is being exercised; or 

(f) With the consent of the Administrator, such other form of legal consideration as may be acceptable to the Administrator. 

4.5 Conditions to Issuance of Stock Certificates. The Shares deliverable upon the exercise of the Option, or any portion thereof, may
be either previously authorized but unissued Shares, treasury Shares or issued Shares which have been purchased on the open market. Such Shares shall be fully paid and nonassessable. The Company shall not be required to issue or deliver any
certificates or make any book entries evidencing Shares purchased upon the exercise of the Option or portion thereof prior to fulfillment of the conditions set forth in Section 11.4 of the Plan. 

4.6 Rights as Stockholder. The holder of the Option shall not be, nor have any of the rights or privileges of, a stockholder of the
Company, including, without limitation, voting rights and rights to dividends, in respect of any Shares purchasable upon the exercise of any part of the Option unless and until such Shares shall have been issued by the Company to such holder (as
evidenced by the appropriate entry on the books of the Company or of a duly authorized transfer agent of the Company). No adjustment shall be made for a dividend or other right for which the record date is prior to the date the Shares are issued,
except as provided in Section 13.2 of the Plan. 

  
 A-4 

 ARTICLE V. 

OTHER PROVISIONS 
 5.1
Administration. The Administrator shall have the power to interpret the Plan and this Agreement as provided in the Plan. All interpretations and determinations made by the Administrator in good faith shall be final and binding upon the
Optionee, the Company and all other interested persons. 
 5.2 Transferability of Option. Without limiting the generality of any
other provision hereof, the Option shall be subject to the restrictions on transferability set forth in Section 11.3 of the Plan. 

5.3 Adjustments. The Optionee acknowledges that the Option is subject to modification and termination in certain events as provided in
this Agreement and Article 13 of the Plan. 
 5.4 Tax Consultation. The Optionee understands that the Optionee may suffer adverse
tax consequences as a result of the grant, vesting and/or exercise of the Option, and/or with the purchase or disposition of the Shares subject to the Option. The Optionee represents that the Optionee has consulted with any tax consultants the
Optionee deems advisable in connection with the purchase or disposition of such shares and that the Optionee is not relying on the Company for any tax advice. 

5.5 Notification of Disposition. If this Option is designated as an Incentive Stock Option, the Optionee shall give prompt notice to
the Company of any disposition or other transfer of any Shares acquired under this Agreement if such disposition or transfer is made (a) within two (2) years from the Grant Date with respect to such Shares or (b) within one
(1) year after the transfer of such Shares to the Optionee. Such notice shall specify the date of such disposition or other transfer and the amount realized, in cash, other property, assumption of indebtedness or other consideration, by the
Optionee in such disposition or other transfer. 
 5.6 Optionee’s Representations. The Optionee shall, if required by the
Company, concurrently with the exercise of all or any portion of this Option, make such written representations as are deemed necessary or appropriate by the Company and/or the Company’s counsel. 

5.7 Section 409A. This Agreement and the Grant Notice shall be interpreted in accordance with the requirements of
Section 409A of the Code. The Administrator may, in its discretion, adopt such amendments to the Plan, this Agreement or the Grant Notice or adopt other policies and procedures (including amendments, policies and procedures with retroactive
effect), or take any other actions, as the Administrator determines are necessary or appropriate to comply with the requirements of Section 409A of the Code or an available exemption thereof; provided, however, that the
Administrator shall have no obligation to take any such action(s) or to indemnify any person from failing to do so. 
 5.8 Amendment,
Suspension and Termination. To the extent permitted by the Plan, this Agreement may be wholly or partially amended or otherwise modified, suspended or terminated at any time or from time to time by the Administrator or the Board; provided,
however, that, except as may otherwise be provided by the Plan, no amendment, modification, suspension or termination of this Agreement shall adversely affect the Option in any material way without the prior written consent of the Optionee. 

5.9 Not a Contract of Service Relationship. Nothing in this Agreement or in the Plan shall confer upon the Optionee any right to
continue to serve as an Employee, Director, Consultant or other service provider of the Company or any of its Affiliates or shall interfere with or restrict in any way the 

  
 A-5 

 
rights of the Company and its Affiliates, which rights are hereby expressly reserved, to discharge or terminate the services of the Optionee at any time for any reason whatsoever, with or without
cause, except to the extent expressly provided otherwise in a written agreement between the Company or an Affiliate and the Optionee. 

5.10 Limitations Applicable to Section 16 Persons. Notwithstanding any other provision of the Plan or this Agreement, if the
Optionee is subject to Section 16 of the Exchange Act, then the Plan, the Option and this Agreement shall be subject to any additional limitations set forth in any applicable exemptive rule under Section 16 of the Exchange Act (including
any amendment to Rule 16b-3 of the Exchange Act) that are requirements for the application of such exemptive rule. To the extent permitted by applicable law, this Agreement shall be deemed amended to the extent necessary to conform to such
applicable exemptive rule. 
 5.11 Conformity to Securities Laws. The Optionee acknowledges that the Plan and this Agreement are
intended to conform to the extent necessary with all provisions of the Securities Act and the Exchange Act, and any and all regulations and rules promulgated by the Securities and Exchange Commission thereunder, as well as all applicable state
securities laws and regulations. Notwithstanding anything herein to the contrary, the Plan shall be administered, and the Option is granted and may be exercised, only in such a manner as to conform to such laws, rules and regulations. To the extent
permitted by applicable law, the Plan and this Agreement shall be deemed amended to the extent necessary to conform to such laws, rules and regulations. 

5.12 Limitation on the Optionee’s Rights. Participation in the Plan confers no rights or interests other than as herein provided.
This Agreement creates only a contractual obligation on the part of the Company as to amounts payable and shall not be construed as creating a trust. The Plan, in and of itself, has no assets. The Optionee shall have only the rights of a general
unsecured creditor of the Company and its Affiliates with respect to amounts credited and benefits payable, if any, with respect to the Option, and rights no greater than the right to receive the Common Stock as a general unsecured creditor with
respect to Options, as and when payable hereunder. 
 5.13 Successors and Assigns. The Company or any Affiliate may assign any of its
rights under this Agreement to single or multiple assignees, and this Agreement shall inure to the benefit of the successors and assigns of the Company and its Affiliates. Subject to the restrictions on transfer set forth in this Article 5, this
Agreement shall be binding upon the Optionee and his or her heirs, executors, administrators, successors and assigns. 
 5.14 Entire
Agreement. The Plan, the Grant Notice and this Agreement (including all Exhibits thereto, if any) constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and its
Affiliates and the Optionee with respect to the subject matter hereof. 
 5.15 Notices. Any notice to be given under the terms of
this Agreement to the Company shall be addressed to the Company in care of the Secretary of the Company at the Company’s principal office, and any notice to be given to the Optionee shall be addressed to the Optionee at the Optionee’s last
address reflected on the Company’s records. Any notice shall be deemed duly given when sent via email or when sent by reputable overnight courier or by certified mail (return receipt requested) through the United States Postal Service. 

5.16 Governing Law. The laws of the State of Delaware shall govern the interpretation, validity, administration, enforcement and
performance of the terms of this Agreement regardless of the law that might be applied under principles of conflicts of laws. 
 5.17
Titles. Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this Agreement. 

  
 A-6 

 EXHIBIT B 

TO STOCK OPTION GRANT NOTICE 

CONSENT OF SPOUSE 

I,
                    , spouse of
                    , have read and approve the Stock Option Grant Notice (the “Grant Notice”) to which this Consent
of Spouse is attached and the Stock Option Agreement (the “Agreement”) attached to the Grant Notice. In consideration of issuing to my spouse the shares of the common stock of Entellus Medical, Inc. set forth in the Grant
Notice, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement and agree to be bound by the provisions of the Agreement insofar as I may have any rights in said Agreement or any shares of the
common stock of Entellus Medical, Inc. issued pursuant thereto under the community property laws or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement.

  

									
	Dated:	 		 		 	
		 		 		 	  
 Signature of
Spouse

  
 B-1EX-10.4(b)

 Exhibit 10.4(b) 

ENTELLUS MEDICAL, INC. 

2015 INCENTIVE AWARD PLAN 

RESTRICTED STOCK UNIT AWARD GRANT NOTICE 

Entellus Medical, Inc., a Delaware corporation, (the “Company”), pursuant to its 2015 Incentive Award Plan (as may be
amended from time to time, the “Plan”), hereby grants to the holder listed below (the “Participant”) an award of restricted stock units (the “RSUs”). Each RSU represents the
right to receive one (1) share of Common Stock (each, a “Share”) in accordance with the terms and conditions hereof if applicable vesting conditions are satisfied. This award of RSUs is subject to all of the terms and
conditions set forth in this Restricted Stock Unit Grant Notice (the “Grant Notice”), the Restricted Stock Unit Award Agreement attached hereto as Exhibit A (together, the “Agreement”) and the
Plan, each of which is incorporated herein by reference. Unless otherwise defined herein, the terms defined in the Plan shall have the same defined meanings in of this Agreement. 

 

			
	Participant:	  	[                            ]
		
	Grant Date:	  	[                            ]
		
	Total Number of RSUs:	  	[            ]
		
	Vesting Commencement Date:	  	[            ]
		
	Vesting Schedule:	  	[                            ]
		
	Termination:	  	If the Participant experiences a Termination of Service prior to the applicable vesting date, all RSUs that have not become vested on or prior to the date of such Termination of Service (after taking into consideration any
vesting that may occur in connection with such Termination of Service, if any) will thereupon be automatically forfeited by the Participant without payment of any consideration therefor.

 By his or her signature below, the Participant agrees to be bound by the terms and conditions of the Plan and
this Agreement. The Participant has reviewed this Agreement and the Plan in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Agreement and fully understands all provisions of this Grant Notice, the
Agreement and the Plan. The Participant hereby agrees to accept as binding, conclusive and final all decisions or interpretations of the Administrator upon any questions arising under the Plan or the Agreement. In addition, by signing below, the
Participant also agrees that the Company, in its sole discretion, may satisfy any withholding obligations in accordance with Section 3.1 of this Agreement by (i) withholding Shares otherwise issuable to the Participant upon full vesting of
the RSUs, (ii) instructing a broker on the Participant’s behalf to sell Shares otherwise issuable to the Participant upon vesting of the RSUs and submit the proceeds of such sale to the Company, or (iii) using any other method
permitted by Section 3.1 of the Agreement or the Plan. If the Participant lives in a community property state and either is married or has a registered domestic partner, his or her spouse has signed the Consent of Spouse attached hereto as
Exhibit B. 
  

									
	ENTELLUS MEDICAL, INC.:	  		  	PARTICIPANT:
					
	By:	 	  
	  		  	By:	 	  

	Print Name:	 	  
	  		  	Print Name:	 	  

	Title:	 	  
	  		  		 	
	Address:	 	  
	  		  	Address:	 	  

 EXHIBIT A 

TO RESTRICTED STOCK UNIT GRANT NOTICE 

RESTRICTED STOCK UNIT AWARD AGREEMENT 

ARTICLE I. 
 GENERAL

 1.1 Incorporation of Terms of Plan. The RSUs are subject to the terms and conditions of the Plan, which are incorporated
herein by reference. In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan shall control. 

ARTICLE II. 
 TERMS AND
CONDITIONS OF RSUS 
 2.1 Grant of RSUs. Upon the terms and conditions set forth in the Plan and this Agreement, effective as of
the Grant Date set forth in the Grant Notice, the Company hereby grants to the Participant an award of RSUs under the Plan in consideration of the Participant’s past and/or future employment with or service to the Company or any Affiliate and
for other good and valuable consideration. In consideration of this grant of RSUs, the Participant agrees to render faithful and efficient services to the Company or its Affiliates. Unless and until the RSUs have fully vested in the manner set forth
in the Grant Notice, the Participant will have no right to receive any Common Stock or other payment in respect of the RSUs. 
 2.2
Vesting of RSUs. The RSUs shall vest and become nonforfeitable, if at all, in accordance with the terms and conditions set forth in the Grant Notice. 

2.3 Payment of RSUs. As soon as administratively practicable following the vesting of any RSUs pursuant to Section 2.2 hereof, but
in no event later than thirty (30) days after such vesting date (for the avoidance of doubt, this deadline is intended to comply with the “short term deferral” exemption from Section 409A of the Code), the Company shall deliver
to the Participant (or the Participant’s Permitted Transferee, if applicable) a number of Shares equal to the number of RSUs subject to this award or RSUs that fully vest on the applicable vesting date (either by delivering one or more
certificates for such Shares or by entering such Shares in book entry form, as determined by the Administrator in its sole discretion). Notwithstanding the foregoing, if Shares cannot be issued within that timeframe pursuant to Section 11.4 of
the Plan (or any successor provision thereto), the Shares shall be issued pursuant to the preceding sentence as soon as administratively practicable after the Administrator determines that Shares can be issued in accordance with such Section. 

2.4 Forfeiture and Termination of RSUs. All RSUs granted under this Agreement shall be forfeited and terminated as set forth in the
Grant Notice. 
 2.5 Conditions to Delivery of Shares. The Company shall not be required to issue or deliver any certificates or make
any book entries evidencing Shares deliverable hereunder prior to fulfillment of the conditions set forth in Section 11.4 of the Plan. 

2.6 Rights as Stockholder. The holder of the RSUs shall not be, nor have any of the rights or privileges of, a stockholder of the
Company, including, without limitation, voting rights and rights to dividends, in respect of the RSUs or any Shares underlying the RSUs unless and until such Shares shall have been issued by the Company and are held of record by such holder (as
evidenced by the appropriate 

  
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entry on the books of the Company or of a duly authorized transfer agent of the Company). No adjustment shall be made for a dividend or other right for which the record date is prior to the date
the Shares are issued, except as provided in Section 13.2 of the Plan. 
 ARTICLE III. 

MISCELLANEOUS PROVISIONS 

3.1 Tax Withholding. The Company shall have the authority and the right to deduct or withhold, or to require the Participant to remit
to the Company (including without limitation, as provided in the Grant Notice), an amount sufficient to satisfy all applicable federal, state and local taxes required by law to be withheld (if any) with respect to any taxable event arising in
connection with the RSUs. The Company shall not be obligated to deliver any new certificate representing Shares to the Participant or the Participant’s legal representative or to enter such Shares in book entry form unless and until the
Participant or the Participant’s legal representative shall have paid or otherwise satisfied in full the amount of all federal, state and local taxes applicable to the taxable income of the Participant arising in connection with the RSUs or
payments thereunder. 
 3.2 Administration. The Administrator shall have the power to interpret the Plan and this Agreement as
provided in the Plan. All interpretations and determinations made by the Administrator in good faith shall be final and binding upon the Participant, the Company and all other interested persons. 

3.3 Grant Not Transferable. Without limiting the generality of any other provision hereof, the RSUs shall be subject to the
restrictions on transferability set forth in Section 11.3 of the Plan. 
 3.4 Adjustments. The Participant acknowledges that the
RSUs are subject to modification and termination in certain events as provided in this Agreement and Article 13 of the Plan. 
 3.5 Tax
Consultation. The Participant understands that the Participant may suffer adverse tax consequences in connection with the RSUs granted pursuant to this Agreement (and any Shares issuable with respect thereto). The Participant represents that
the Participant has consulted with any tax consultants the Participant deems advisable in connection with the RSUs and the issuance of Shares with respect thereto and that the Participant is not relying on the Company for any tax advice. 

3.6 Participant’s Representations. The Participant shall, if required by the Company, concurrently with the issuance of any
securities hereunder, make such written representations as are deemed necessary or appropriate by the Company and/or the Company’s counsel. 

3.7 Section 409A. This Agreement shall be interpreted in accordance with the requirements of Section 409A of the Code. The
Administrator may, in its discretion, adopt such amendments to the Plan or this Agreement or adopt other policies and procedures (including amendments, policies and procedures with retroactive effect), or take any other actions, as the Administrator
determines are necessary or appropriate to comply with the requirements of Section 409A of the Code or an available exemption therefrom, provided, however, that the Administrator shall have no obligation to take any such action(s) or to
indemnify any person for failing to do so. 
 3.8 Amendment, Suspension and Termination. To the extent permitted by the Plan, this
Agreement may be wholly or partially amended or otherwise modified, suspended or terminated at any time or from time to time by the Administrator or the Board; provided, however, that, except as may otherwise be provided by the Plan, no
amendment, modification, suspension or termination of this Agreement shall adversely affect the RSUs in any material way without the prior written consent of the Participant. 

  
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 3.9 Not a Contract of Service Relationship. Nothing in this Agreement or in the Plan shall
confer upon the Participant any right to continue to serve as an Employee, Director, Consultant or other service provider of the Company or any of its Affiliates or shall interfere with or restrict in any way the rights of the Company and its
Affiliates, which rights are hereby expressly reserved, to discharge or terminate the services of the Participant at any time for any reason whatsoever, with or without Cause, except to the extent expressly provided otherwise in a written agreement
between the Company or an Affiliate and the Participant. 
 3.10 Limitations Applicable to Section 16 Persons. Notwithstanding
any other provision of the Plan or this Agreement, if the Participant is subject to Section 16 of the Exchange Act, then the Plan, the RSUs and this Agreement shall be subject to any additional limitations set forth in any applicable exemptive
rule under Section 16 of the Exchange Act (including any amendment to Rule 16b-3 of the Exchange Act) that are requirements for the application of such exemptive rule. To the extent permitted by applicable law, this Agreement shall be deemed
amended to the extent necessary to conform to such applicable exemptive rule. 
 3.11 Conformity to Securities Laws. The Participant
acknowledges that the Plan and this Agreement are intended to conform to the extent necessary with all provisions of the Securities Act and the Exchange Act, and any and all regulations and rules promulgated by the Securities and Exchange Commission
thereunder, as well as all applicable state securities laws and regulations. Notwithstanding anything herein to the contrary, the Plan shall be administered, and the RSUs are granted, only in such a manner as to conform to such laws, rules and
regulations. To the extent permitted by applicable law, the Plan and this Agreement shall be deemed amended to the extent necessary to conform to such laws, rules and regulations. 

3.12 Limitation on the Participant’s Rights. Participation in the Plan confers no rights or interests other than as herein
provided. This Agreement creates only a contractual obligation on the part of the Company as to amounts payable and shall not be construed as creating a trust. The Plan, in and of itself, has no assets. The Participant shall have only the rights of
a general unsecured creditor of the Company and its Affiliates with respect to amounts credited and benefits payable, if any, with respect to the RSUs, and rights no greater than the right to receive the Common Stock as a general unsecured creditor
with respect to RSUs, as and when payable hereunder. 
 3.13 Successors and Assigns. The Company or any Affiliate may assign any of
its rights under this Agreement to single or multiple assignees, and this Agreement shall inure to the benefit of the successors and assigns of the Company and its Affiliates. Subject to the restrictions on transfer set forth in Section 3.3
hereof, this Agreement shall be binding upon the Participant and his or her heirs, executors, administrators, successors and assigns. 

3.14 Entire Agreement. The Plan, the Grant Notice and this Agreement (including all Exhibits thereto, if any) constitute the entire
agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and its Affiliates and the Participant with respect to the subject matter hereof. 

3.15 Notices. Any notice to be given under the terms of this Agreement to the Company shall be addressed to the Company in care of the
Secretary of the Company at the Company’s principal office, and any notice to be given to the Participant shall be addressed to the Participant at the Participant’s last address reflected on the Company’s records. Any notice shall be
deemed duly given when sent via email or when sent by reputable overnight courier or by certified mail (return receipt requested) through the United States Postal Service. 

  
 A-3 

 3.16 Governing Law. The laws of the State of Delaware shall govern the interpretation,
validity, administration, enforcement and performance of the terms of this Agreement regardless of the law that might be applied under principles of conflicts of laws. 

3.17 Titles. Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this
Agreement. 

  
 A-4 

 EXHIBIT B 

TO RESTRICTED STOCK UNIT GRANT NOTICE 

CONSENT OF SPOUSE 
 I,
                            , spouse of
                            , have read and approve the Restricted Stock Unit Grant Notice (the
“Grant Notice”) to which this Consent of Spouse is attached and the Restricted Stock Unit Agreement (the “Agreement”) attached to the Grant Notice. In consideration of issuing to my spouse the shares
of the common stock of Entellus Medical, Inc. set forth in the Grant Notice, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement and agree to be bound by the provisions of the Agreement
insofar as I may have any rights in said Agreement or any shares of the common stock of Entellus Medical, Inc. issued pursuant thereto under the community property laws or similar laws relating to marital property in effect in the state of our
residence as of the date of the signing of the foregoing Agreement. 
  

									
	Dated:	 	  
	 		  	  
	  	
		 		 		  	Signature of Spouse	  	

  
 B-1

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