AGREEMENT

         THIS AGREEMENT  ("Agreement")  is dated  September 1, 1998 by and among
Women's Medical & Diagnostic Center, Inc., a Florida corporation, with its place
of business at 222 S.W. 36th Terrace, Gainesville,  Florida ("WMDC"), IntegraMed
America,  Inc., a Delaware corporation,  with its principal place of business at
One Manhattanville Road,  Purchase,  New York 10577 ("INMD") and Florida Medical
and Research Institute, P.A., a Florida professional association, with its place
of business at 6440 N.W.  Newberry Road, Suite 204,  Gainesville,  Florida 32605
("FMRI").
                                                     RECITALS:
         WMDC is a wholly-owned subsidiary of INMD conducting a medical practice
in the State of Florida;

         INMD and FMRI have  entered into a Memorandum  of  Understanding  dated
August 24, 1998 ("MOU") pursuant to which,  among other things,  INMD has agreed
to sell certain WMDC accounts receivable to FMRI; and

         WMDC has agreed to assign certain Clinical Research Trials to FMRI.

         NOW THEREFORE,  in  consideration  of the mutual promises and covenants
herein contained, the parties hereto agree as follows:

         1.  RIGHT  TO  CLINICAL   ACCOUNTS   RECEIVABLE.   The  parties  hereby
acknowledge  and agree that,  during the  operation  of WMDC,  certain  accounts
receivable were generated in connection  with medical and/or  clinical  services
rendered by WMDC ("Clinical  Receivables").  For the purposes of this Agreement,
Clinical  Receivables  are deemed  generated on the date that the medical and/or
clinical service or treatment is provided to a patient, irrespective of the date
(before or after  treatment)  that  payment is  actually  received.  The parties
hereby agree and acknowledge the following  rights and interests in the Clinical
Receivables:






         (a) Any and all  Clinical  Receivables  generated on or prior to August
         31, 1998 ("Pre- Closing Clinical Receivables") are the sole property of
         WMDC,  whether  payment  therefor has, or in the future is, received by
         WMDC or  FMRI.  Any  and all  payments  received  by FMRI on and  after
         September 1, 1998 for Pre-Closing Clinical Receivables will be promptly
         forwarded  to  IntegraMed  America,   Inc.,  One  Manhattanville  Road,
         Purchase,  New  York  10577,   Attention:   John  Kearns,  Director  of
         Accounting (b) Any and all Clinical Receivables  generated on and after
         September 1, 1998 ("Post- Closing Clinical  Receivables")  are the sole
         property of FMRI,  whether  payment  therefor has, or in the future is,
         received by INMD or FMRI.  Any and all payments  received by WMDC on or
         after September 1, 1998 for Post-Closing  Clinical  Receivables will be
         promptly forwarded to FMRI, Attention:  Accounts Receivable Department.
         Nothing contained herein shall be construed to obligate FMRI to collect
         the  Pre-Closing  Clinical  Receivables  generated  by WMDC;  provided,
         however,  FMRI shall give WMDC and INMD access,  from time to time,  as
         reasonably  needed,  to the data  supporting the  Pre-Closing  Clinical
         Receivables,  and,  if  necessary,  give  WMDC or INMD  representatives
         access to FMRI's office at 222 SW 36th Terrance, Gainesville,  Florida,
         on reasonable  notice,  in pursuit of collecting  Pre-Closing  Clinical
         Receivables.  (c) In the event there arises a dispute  between WMDC and
         FMRI as to the nature and  character  of the Clinical  Receivable,  the
         parties shall first rely on the date the service was rendered, as shown
         on the computer  records  generated by WMDC. FMRI shall have the burden
         of proving  such records  erroneous by supplying  copies of the patient
         medical  records.  FMRI shall not be  responsible  for any  refunds due
         patients for services rendered prior to September 1, 1998.





       
         2. RIGHT TO CLINICAL RESEARCH ACCOUNTS  RECEIVABLE.  The parties hereby
acknowledge  and agree that,  during the  operation  of WMDC,  certain  accounts
receivable were generated in connection with clinical research services rendered
by WMDC ("Research Receivables").  For the purposes of this Agreement,  Research
Receivables  are deemed  generated on the date that the medical and/or  clinical
service, or treatment is provided to a patient, irrespective of the date (before
or after treatment) that payment is actually received.  The parties hereby agree
and  acknowledge  that  any and all  Research  Receivables  generated  prior  to
September  1, 1998 are being  assigned  to FMRI,  and WMDC does  hereby  assign,
transfer  and  convey  such  Research  Receivables  as set forth on  Exhibit  A,
attached  hereto,  to  FMRI in  consideration  for the  payment  of  One-Hundred
Sixty-Five  Thousand  Dollars  ($165,000.00),  the  receipt  of which is  hereby
acknowledged.  To the best of WMDC's knowledge and belief,  Exhibit A represents
Research Receivables as of August 31, 1998.

         3.  CLINICAL  RESEARCH.  Marvin  Heuer,  MD,  Medical  Director of WMDC
("Heuer")  is the  Research  Scientist  or  Principal  Investigator  for various
clinical trials  ("Clinical  Trials") being conducted by WMDC. All such Clinical
Trials  are  hereby   assigned  to  FMRI.   Neither  WMDC  nor  INMD  makes  any
representation  or warranty  that the Clinical  Trials are  assignable or can be
assigned  to FMRI;  however,  WMDC will use its best  efforts to assist with the
assignment of such Clinical Trials to FMRI. WMDC hereby assigns all new research
protocols whichwould have been contractually awarded to WMDC, or to Heuer in his
role as WMDC's  employee,  to FMRI, and will use its best efforts to assist with
any such assignment.

         4. CLINICAL  CHARTS.  Effective  September 1, 1998,  FMRI shall assume
responsibility  for all  patient  charts  maintained  by  WMDC,  other  than the
patients of Drs. Hinshaw, Markle and Sample.





         5.  FURNISHINGS  AND  EQUIPMENT.  Pursuant to  paragrapgh  8 of the MOU
certain equipment and furnishings  located at the Ocala and Gainesville  offices
are being  conveyed  to FMRI,  effective  the date  hereof.  Attached  hereto as
Exhibit B is a listing of such furnishings and equipment.

         6.  CONFLICT.  Except  as may be  modified  herein,  all the  terms and
conditions of the MOU remain in full force and effect.  In the event any term or
condition  herein is  inconsistent  with or is in  conflict  with the MOU,  this
Agreement shall control.

         7.  INDEMNIFICATION

                  (a) WMDC and INMD agree to indemnify and hold  harmless  FMRI,
its directors,  officers,  employees and agents from any suits, claims, actions,
losses, liabilities or expenses (including reasonable attorneys' fees and costs)
arising out of or in connection with any act or failure to act by either of them
during the  operations of WMDC.  To the best of INMD's and WMDC's  knowledge and
belief,  all  incidents  that  potentiate  a claim have been  reported  to their
professional liability insurer.

                  (b) FMRI agrees to indemnify  and hold harmless WMDC and INMD,
their  respective  officers,  directors,  employees and agents,  from any suits,
claims, actions, losses, liabilities or expenses (including reasonable attorneys
fees and costs)  arising out of or in connection  with any act or failure to act
by it after September 1, 1998.

         8.  PROFESSIONAL  LIABILITY  INSURANCE.  WMDC  agrees  to keep  medical
malpractice  coverage in place for Heuer until such time,  not to exceed 60 days
from September 1, 1998, that Heuer effects such coverage in his own name.








         9.  COOPERATION.    In   the   event   of   any   claims,    suits   or
governmentalinvestigations, arising out of or relating to the operations of WMDC
in  which  WMDC,  INMD or FMRI or an  individual  of  either  shall  be named or
involved whether occurring or pending prior to this Agreement, the parties agree
to cooperate with each other in the defense of such suit, claim or investigation
by the production of any documents in their  possession for review.  The parties
shall,  as soon as  practical,  deliver to each other  copies of any  summonses,
complaints,  suit letters,  subpoenas or legal papers of any kind, served upon a
party or a party's attorneys. Nothing in this Section shall obligate the parties
to pay any legal fees incurred by the other.

         10. GOVERNING LAW. This Agreement shall be governed by and construed in
accordance with the laws of the State of Florida. Any and all claims,  disputes,
or controversies  arising under, out of, or in connection with this Agreement or
any breach thereof,  shall be determined by binding  arbitration in the State of
Florida, City of Gainesville  (hereinafter  "Arbitration");  provided,  however,
mediation shall be a precursor to Arbitration.  The party seeking  determination
shall  subject  any  such   dispute,   claim  or   controversy   to  either  (i)
JAMS/Endispute or (ii) the American  Arbitration  Association,  and the rules of
commercial  arbitration  of the selected  entity shall govern.  The  Arbitration
shall be  conducted  and  decided by three (3)  arbitrators,  unless the parties
mutually agree, in writing at the time of the Arbitration, to fewer arbitrators.
In reaching a decision,  the arbitrators  shall no authority to change or modify
any provision of this Agreement,  including without  limitation,  any liquidated
damages  provision.  Each party shall bear its own  expenses  and  one-half  the
expenses and costs of the  arbitrators.  Any application to compel  arbitration,
confirm or vacate an arbitral award or otherwise enforce this Paragraph shall be
brought either in the Courts of the State of Florida.








         11. Notices.  All notices,  requests,  demands and other communications
provided for in this Agreement or required among the parties in connection  with
this Agreement shall be in writingand  shall be deemed to have been given at the
time when  personally  delivered,  mailed at any United  States  Post Office via
certified mail, prepaid, return receipt requested, or sent by overnight delivery
services against receipt,  addressed to the party at the address set forth below
or such other address as such party may designate by notice:

         If to INMD or WMDC:
                  Mr. Jay Higham, Vice President
                  IntegraMed America, Inc.
                  One Manhattanville Road
                  Purchase, New York 10577

         With a Copy to:
                  Claude E. White, General Counsel
                  IntegraMed America, Inc.
                  One Manhattanville Road
                  Purchase, New York 10577

         If to FMRI:
                  Marvin Heuer, MD, President
                  Florida Medical and Research Institute, P.A.
                  6640 N.W. Newberry Road
                  Gainesville, Florida 32605

         With a Copy to:

                  Ellen Gershow, Esq.
                  Dell Graham, P.A.
                  P.O. Box 850
                  203 N.E. 1st Street
                  Gainesville, Florida 32601

         12. SEVERABILITY.  Each  provision in this  Agreement is intended to be
severable,  and may be modified by any court of  competent  jurisdiction  to the
extent  necessary to make such provision valid and  enforceable.  If any term or
provision hereof shall be determined by a court of competent  jurisdiction to be
illegal  or  invalid  for any  reason  whatsoever,  in whole  or in  part,  such
provision shall be severed from this Agreement and shall not effect the validity
of the remainder of this Agreement.





         13.  INDEPENDENT  STATUS.  The  Parties  agree that FMRI is  purchasing
assets and  certain  receivables  of WMDC and  accepting  assignment  of certain
leases and agreements. Nothing contained herein or with respect to any aspect of
the transaction  shall be construed to constitute FMRI as a related or successor
party-in-interest to WMDC.

         14. TELEPHONE  NUMBERS.  WMDC hereby assigns its right to the telephone
numbers  previously  used  by it to FMRI  and  agrees  to  execute  any  further
documentation necessary to transfer such numbers.

         IN WITNESS  WHEREOF,  the parties have executed this Agreement the date
first above written. WOMEN'S MEDICAL & DIAGNOSTIC CENTER, INC.


By: /s/Jay Higham
    -----------------------------
    Jay Higham, Vice President


FLORIDA MEDICAL AND RESEARCH INSTITUTE, P.A.

By: /s/Marvin Heuer
    ------------------------------
    Marvin Heuer, MD, President



INTEGRAMED AMERICA, INC.


By: /s/Jay Higham
    ------------------------------
    Jay Higham, Vice President