Document:

Exhibit 10.42

                                 PROMISSORY NOTE

$175,000                          Dallas, Texas                 February 7, 2006

         FOR  VALUE  RECEIVED,  the  undersigned,  MedSolutions,  Inc.,  a Texas
corporation (the "Maker"),  hereby unconditionally  promises to pay to the order
of On Call  Medical  Waste  Service,  Ltd.,  a Texas  limited  partnership  (the
"Payee"), at such place as designated by the Payee, or at such other place or to
such other party or parties as may be designated by the Payee from time to time,
in lawful  money of the United  States of  America,  the  principal  amount (the
"Principal Amount") of $175,000, with simple interest at the rate of 12.0%.

         1.  This  Promissory  Note (the  "Note")  shall be due and  payable  in
monthly  installments  of interest only  beginning  March 7, 2006 with the final
installment  of  principal  and  accrued  interest  due on January 31, 2007 (the
"Maturity  Date") provided  further,  however,  that if a payment date hereunder
should fall on a Saturday, Sunday, or bank holiday, then such payment date shall
be the next  business  day. The Maker may prepay any portion or this entire Note
without  penalty  at any time.  Any  prepayment  will be applied  first  against
accrued but unpaid interest and then against the outstanding  principal balance.
At the request of the Payee,  the Maker may make any payments due under the Note
directly to the creditors of the Payee.

         2. If the Maker  fails to pay the full  amount  then due on any Payment
Date and such failure remains uncured for a period of 10 calendar days following
written notice of such default by the Payee, then, at the election of the Payee,
this Note shall  immediately  become due and  payable in full,  interest on such
principal  amount and unpaid interest shall  thereafter  accrue at the lesser of
14% or the highest lawful rate  permissible  under  applicable law (the "Default
Rate"),  and the Payee  shall be  entitled  to pursue  any remedy to which it is
entitled under applicable law.

         3. The makers,  signers,  sureties,  guarantors,  and endorsers of this
Note severally waive  valuation and appraisal,  demand,  presentment,  notice of
dishonor,  notice of intent to demand or accelerate  payment  hereof,  notice of
demand,  notice of acceleration,  diligence in collecting,  grace,  notice,  and
protest. If this Note is not paid when due, the Maker agrees to pay all costs of
collection,  including,  but not limited to, reasonable  attorneys' fees and all
expenses  incurred  by the  holder  hereof on  account  of any such  collection,
whether or not suit is filed hereon.

         4. Except as expressly  set forth in Section 1 hereof,  the Maker shall
have no right of  setoff,  counterclaim,  recoupment  or  other  deduction  with
respect to the payment  required  hereunder,  and such payment  constitutes  the
absolute and unconditional obligation of the Maker.

         5. Each  right and  remedy  available  to the  holder  hereof  shall be
cumulative  of and in addition to each other such right and remedy.  No delay on
the part of the holder  hereof in the exercise of any right or remedy  available
to the holder hereof shall operate as a waiver thereof,  nor shall any single or
partial  exercise thereof preclude other or further exercise thereof or exercise
of any other such right or remedy.

         6.  Regardless  of any  provision  contained in this Note,  Payee shall
never be entitled to receive,  collect or apply,  as interest on this Note,  any
amount in excess of the maximum  lawful rate permitted by applicable law and, in
the event Payee ever receives,  collects or applies as interest any such excess,
such  amount  that  would  be  excessive  interest  shall be  deemed  a  partial
prepayment  of  principal  and  treated  under  this Note as such by  Maker.  In
determining  whether or not the  interest  paid or payable on this Note  exceeds
such maximum lawful rate, Maker and Payee shall, to the maximum extent permitted

<PAGE>

under applicable law, (a)  characterize any nonprincipal  payment as an expense,
fee or premium rather than as interest,  (b) exclude  voluntary  prepayments and
the effects thereof,  and (c) amortize,  prorate,  allocate and spread, in equal
parts, the total amount of interest  throughout the entire  contemplated term of
this Note so that the interest  rate does not exceed the maximum  lawful rate at
any time during the entire term of this Note.  However,  if this Note is paid in
full or all or a portion of the  principal  is set off under the Asset  Purchase
Agreement prior to the scheduled  maturity hereof,  and if the interest received
for the actual  period of existence  thereof  exceeds such maximum  lawful rate,
Payee  shall  refund the  amount of such  excess and shall not be subject to any
applicable penalties provided by any laws for contracting for, charging, taking,
reserving or receiving interest in excess of such maximum lawful rate.

         7. Payee  shall be  entitled to assign all or a portion of this Note to
an Affiliate (as such term is defined in the Asset Purchase  Agreement  dated of
even date herewith by and between Maker and Payee) without the consent of Maker.
Maker shall reissue the Note to the transferee(s) upon receipt of written notice
of the transfer and evidence of transferee(s)' status as an Affiliate.

         8. THIS  NOTE  SHALL BE  GOVERNED  BY AND  CONSTRUED  AND  ENFORCED  IN
ACCORDANCE  WITH THE LAWS OF THE  STATE OF TEXAS  WITHOUT  GIVING  EFFECT TO THE
CONFLICT OF LAWS RULES OR CHOICE OF LAWS RULES THEREOF.

            EXECUTED effective as of the date first set forth above.

                                            MAKER:

                                            MedSolutions, Inc.

                                            By: /s/ Matthew H. Fleeger
                                               ---------------------------------
                                               Matthew H. Fleeger, President/CEO

                                            ACCEPTED BY:

                                            On Call Medical Waste, LTD

                                            By: /s/ Dwight Strouse
                                               ---------------------------------
                                               Dwight Strouse, General PartnerExhibit 10.43

                     FIRST AMENDMENT TO INVESTMENT AGREEMENT

         THIS FIRST  AMENDMENT TO  INVESTMENT  AGREEMENT is executed and entered
into as of the 15th day of March, 2006, by and between Tate Investments,  LLC, a
Wisconsin limited liability company (the "Investor"), and MedSolutions,  Inc., a
Texas corporation, on behalf of itself and its subsidiaries (MedSolutions,  Inc.
and its subsidiaries are collectively referred to as the "Company").

                                    RECITALS:

         WHEREAS,  Company and  Investor  entered into an  Investment  Agreement
dated as of July 15, 2005 (the "Investment Agreement"); and

         WHEREAS,  the  Investor has agreed to extend  additional  credit to the
Company in accordance  with the terms of a Loan  Agreement of even date herewith
and  the  Convertible   Promissory  Note  and  Security  Agreement  executed  in
connection  therewith  (the  Loan  Agreement,  Convertible  Promissory  Note and
Security Agreement are referred to collectively as the "Loan Documents"); and

         WHEREAS,  the parties desire to amend the  Investment  Agreement as set
forth herein.

         NOW,  THEREFORE,  in consideration of the promises and mutual covenants
contained in this Agreement and the Loan Documents, the Company and the Investor
agree as follows:

         1. Subsection  3.2(j) of the Investment  Agreement is hereby amended by
deleting  the  first  sentence  of such  subsection  and  replacing  it with the
following:

         "As  collateral  security  for the  prompt  and  complete  payment  and
performance when due of the Company's  obligations  under this Agreement and the
Note,  the Company does hereby grant the  Investor a continuing  first  priority
security interest in and to the collateral  described in the Security  Agreement
dated as of March 15, 2006  between  Company and  Investor,  the Accounts of the
Company and its Subsidiaries,  and a continuing  mortgage interest in and to the
Real Property (collectively the "Collateral")."

         2.  Subsections  9.1 (a), (b) and (c) of the  Investment  Agreement are
amended by deleting such subsections and replacing them with the following:

         "(a) The  Company  defaults  in any payment due under the Note or under
the  terms  of the  Loan  Agreement,  Convertible  Promissory  Note or  Security
Agreement  dated as of March  15,  2006,  by and  between  the  Company  and the
Investor (the "Loan Documents");

         (b) Any representation or warranty made by the Company herein or in the
Loan  Documents  shall be false in any material  respect on the date as of which
made;

                                       1
<PAGE>

         (c) The Company fails to materially  perform or observe any  agreement,
covenant, term or condition in this Agreement,  any of the Transaction Documents
or any of the Loan Documents;"

         3.  Subsections  9.2(a) and (c) are hereby  amended  by  deleting  such
subsections and replacing them with the following:

         "(a) Declare all outstanding sums under the Note and the Loan Documents
to be, and such sums shall thereupon be and become, immediately due and payable;
         (c) Proceed to protest and enforce its rights under this Agreement, the
Note, the Transaction  Documents and the Loan Documents,  by exercising all such
remedies available to the Investor in respect thereof under applicable law."

         4. Except as set forth herein,  the terms of the  Investment  Agreement
shall continue unmodified and in full force and effect.

         5. Any  capitalized  term used in this Agreement which is not otherwise
defined  herein,  shall  have  the  meaning  ascribed  to it in  the  Investment
Agreement.

         IN WITNESS  WHEREOF,  the parties have  executed  this  Agreement to be
effective as the day first above written.

THE COMPANY:                                          THE INVESTOR:

MedSolutions, Inc.                                    Tate Investments, LLC
                                                      By: Tate Revocable Trust
By: /s/ Matthew H. Fleeger
   -----------------------
   Matthew H. Fleeger,                                By: /s/ Joseph P. Tate
   President and CEO                                     -----------------------
                                                         Joseph P. Tate, Trustee

                                       2

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00102-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00102-of-00352.parquet"}]]