Loan  Agreement  dated as of  September  11,  1998  between  INTEGRAMED
AMERICA,  INC., a Delaware  corporation  with its chief place of business at One
Manhattanville  Road,  Purchase,  New York 10577-2100 (the "Borrower") and FLEET
BANK,  NATIONAL  ASSOCIATION,  a national banking  association,  244 Westchester
Avenue, White Plains, New York 10604 (the "Bank").

         The parties hereto hereby agree as follows:

1.       DEFINITIONS.

1.1      Defined  Terms.  As used  herein  the  following  terms  shall have the
following meanings:

         "Accounts"  shall mean those  accounts  (i)  arising out of the sale or
lease of goods or the rendition of services by the Borrower, or (ii) acquired by
the Borrower from another Person.

         "Account  Debtor" shall mean the person who is obligated on or under an
Account.

         "Acquisition"  shall mean with  respect to any Person,  the purchase or
other acquisition by such Person, by any means whatsoever  (including  through a
merger, amalgamation,  dividend or otherwise and whether in a single transaction
or in a series of related  transactions),  of (i) any Capital Stock of any other
Person  if,  immediately  thereafter,  such  other  Person  would  be  either  a
Subsidiary  of such Person or otherwise  under the control of such Person,  (ii)
any business, going concern or division or segment of any other Person, or (iii)
any Property of any other Person other than in the ordinary  course of business,
provided, however, that no acquisition of all or substantially all of the assets
of such other Person  shall be deemed to be in the ordinary  course of business.
Acquisition  shall  exclude  Capital   Expenditures  (as  hereinafter   defined)
otherwise  permitted  by  this  agreement.  For  purposes  of  this  definition,
"Acquisition"  shall take the form of the Borrower's  entering into a Management
Agreement and the  Borrower's  acquisition of certain fixed assets in connection
therewith.

         "Acquisition  Cost" shall mean with respect to any  Acquisition  by any
Person,  the sum of (i) all cash consideration paid or agreed to be paid by such
Person to make such  Acquisition  (inclusive  of  payments by such Person of the
seller's  professional  fees and expenses and other out-of-  pocket  expenses in
connection  therewith),  plus  (ii)  the  fair  market  value  of  all  non-cash
consideration paid by such Person in connection therewith,  plus (iii) an amount
equal to the principal or stated amount of all  liabilities  assumed or incurred
by such Person in  connection  therewith.  The principal or stated amount of any
liability  assumed or incurred  by a Person in  connection  with an  Acquisition
which is a contingent liability shall be an amount equal to the stated amount of
such liability or, if the same is not stated, the maximum reasonably anticipated
amount payable by such Person in respect thereof as determined by such Person in
good faith.

                                      

                                       1



         "Adjusted Net Income" shall mean,  with respect to the Borrower and its
Subsidiaries on a consolidated basis for any period, the net income (or loss) of
the  Borrower  and its  Subsidiaries  on a  consolidated  basis for such period,
excluding extraordinary items, as determined in accordance with GAAP.

         "Affiliate"  as  applied  to any  Person  shall  mean any other  Person
directly  or  indirectly  through  one  or  more   intermediaries   controlling,
controlled  by, or under common control with,  that Person.  For the purposes of
this  definition,  "control"  (including with  correlative  meanings,  the terms
"controlling",  "controlled by" and "under common control with"),  as applied to
any Person, means the possession, directly or indirectly, of the power to direct
or cause the direction of the  management  and policies of that Person,  whether
through the ownership of voting securities or by contract or otherwise.

         "Agreement"  shall mean this Loan  Agreement,  as the same from time to
time may be amended, supplemented or modified.

         "Applicable Margin" shall mean:

         (a)  with  respect  to the  unpaid  principal  balance  of  Facility  A
Revolving  Credit Loans that consist of Fluctuating  Rate Loans and LIBOR Loans,
in each case at all times during which the  applicable  Pricing  Level set forth
below is in effect,  the  percentage  set forth below next to such Pricing Level
and under the applicable column:

                                  Applicable Margin (Type of Loan)
                                  --------------------------------

                                  Fluctuating 
         Pricing Level             Rate Loan       LIBOR Loan
         -------------             ---------       ----------

         Pricing Level I              0.25%           3.00%
         Pricing Level II             0.00%           2.75%
         Pricing Level III            0.00%           2.25%

         (b)  with  respect  to the  unpaid  principal  balance  of  Facility  B
Revolving Credit Loans and Term Loans that consist of Fluctuating Rate Loans and
LIBOR Loans, in each case at all times during which the applicable Pricing Level
set forth  below is in  effect,  the  percentage  set forth  below  next to such
Pricing Level and under the applicable column:

                                  Applicable Margin (Type of Loan)
                                  --------------------------------

                                  Fluctuating 
         Pricing Level             Rate Loan       LIBOR Loan
         -------------             ---------       ----------

         Pricing Level I             0.00%            2.75%
         Pricing Level II            0.00%            2.50%
         Pricing Level III           0.00%            2.25%


                                       2


         In each of the above cases,  changes in the Applicable Margin resulting
from  a  change  in  a  Pricing   Level  shall  be  based  upon  the   financial
statements/certificate  most recently  delivered  pursuant to Sections 5.2(a)(i)
and 5.2(b) and shall become  effective on the date such financial  statements or
certificate,  as applicable, are delivered to the Bank in the format required by
this  Agreement.  Notwithstanding  anything to the  contrary  contained  in this
definition,  (i) if, at any time and from time to time, the Borrower shall be in
Default of its  obligations  under  Section 5.2,  Pricing  Level I (as increased
pursuant to Section  2.11(c)) shall apply until such Default is cured,  and (ii)
Pricing  Level I shall apply  during the period  commencing  on the date of this
Agreement  and  ending  on the  date of  delivery  thereafter  of the  financial
statements/certificate  covering  the fiscal  period of the  Borrower  ending on
March 31, 1999.

         "Borrowing Base" shall mean at any time 50% of the Borrower's  Eligible
Accounts Receivable at such time.

         "Borrowing Base Certificate" shall mean a certificate  substantially in
the form of Exhibit D hereto.

         "Business Day" shall mean a day other than a Saturday,  Sunday or other
day on which  commercial  banks in New York are  required or permitted by law to
remain  closed,  except that  "Business  Day" in the context of a specific  city
shall mean any date on which commercial banks are open for business in that city
and relative to the date of (i) making or continuing any Loans as, or converting
any Loans from or into,  LIBOR Loans,  (ii) making any payment or  prepayment of
principal  of or payment of interest on any portion of the  principal  amount of
any Loans being  maintained as LIBOR Loans,  or (iii) the Borrower's  giving any
notice  (or the number of  Business  Days to elapse  prior to the  effectiveness
thereof) in connection with any matter  referred to in the foregoing  clause (i)
or (ii),  any day on which  dealings in Dollars are carried on in the  interbank
eurodollar market in London, England.

         "Capital  Expenditures"  shall mean for any period,  the  additions  to
property,  plant and equipment and other capital expenditures of such Person for
such period as the same are or would be set forth in a consolidated statement of
cash flows of such  Person for such  period (or the notes  thereto)  prepared in
accordance with generally  accepted  accounting  principles,  excluding any such
additions which are attributable to an Acquisition.

         "Capitalized Lease" shall mean any lease the obligations to pay rent or
other amounts under which constitute Capitalized Lease Obligations.

         "Capitalized  Lease  Obligations"  shall  mean  as to any  Person,  the
obligations  of such  Person to pay rent or other  amounts  under a lease of (or
other agreement  conveying the right to use) real and/or personal property which
obligations are required to be capitalized  under GAAP and, for purposes of this
Agreement,  the  amount  of such  obligations  shall be the  capitalized  amount
thereof, determined in accordance with GAAP.


                                       3

   
        "Capital  Stock"  shall mean as to any Person,  all shares,  interests,
partnership  interests,  limited  liability company  interests,  participations,
rights in or other  equivalents  (however  designated)  of such Person's  equity
(however  designated) and any rights,  warrants or options  exchangeable  for or
convertible into such shares, interests, participations, rights or other equity.

         "Cash  Equivalents" means (a) securities with maturities of one year or
less from the date of acquisition  issued or fully  guaranteed or insured by the
United States  Government or any agency thereof,  (b) certificates of deposit or
eurodollar  time deposits  with  maturities of one year or less from the date of
acquisition and overnight bank deposits of any commercial bank having capital in
excess of  $200,000,000,  (c)  repurchase  obligations  of any  commercial  bank
satisfying the requirements of clause (b) of this definition,  having a term not
more than seven days with respect to  securities  issued or fully  guaranteed or
insured by the United  States  Government,  (d)  commercial  paper of a domestic
issuer rated at least A-1 or the equivalent thereof by Standard & Poor's Ratings
Group ("S&P") or P-1 or the equivalent  thereof by Moody's  Investors  Services,
Inc.  ("Moody's")  and in either case maturing  within one year from the date of
acquisition, (e) securities with maturities of one year or less from the date of
acquisition  issued or fully guaranteed by any state,  commonwealth or territory
of the United States,  by any political  subdivision or taxing  authority of any
such  state,  commonwealth  or  territory  or by  any  foreign  government,  the
securities  of which  state,  commonwealth,  territory,  political  subdivision,
taxing authority or foreign government (as the case may be) are rated at least A
by S&P or A by Moody's,  (f) securities with maturities of one year or less from
the date of  acquisition  backed by  standby  letters  of  credit  issued by any
commercial bank satisfying the  requirements of clause (b) of this definition or
(g) shares of money market mutual or similar funds which invest  exclusively  in
assets   satisfying  the  requirements  of  clauses  (a)  through  (f)  of  this
definition.

         "Change in  Control"  shall mean that after the date of this  Agreement
the ownership of the Borrower's outstanding Capital Stock shall change such that
any one  Person  or any  one  group  of  Affiliated  Persons  owns  directly  or
beneficially  more than 50% of the issued and  outstanding  Capital Stock of the
Borrower.

         "Cleanup  Laws"  shall  mean any  federal,  state or local  statute  or
regulation  relating to hazardous or toxic wastes or  substances  or the removal
thereof.

         "Collateral"  shall mean the collateral  described in Section 9 of this
Agreement.

         "Commitment" shall mean the Facility A Commitment and/or the Facility B
Commitment.

         "Commitment  Letter"  shall  mean  the  letter  agreement  between  the
Borrower and the Bank dated July 16, 1998.

         "Commitment  Period" shall mean the Facility A Commitment Period and/or
the Facility B Commitment Period.

                                       4


         "Consolidated"  or  "consolidated"  shall  mean  the  Borrower  and its
Subsidiaries on a consolidated basis in accordance with GAAP.

         "Consolidated  Adjusted  EBITDA" shall mean,  for any period,  (i) with
respect  to  Network  Sites  owned  by the  Borrower  for more  than 12  months,
Consolidated EBITDA and (ii) with respect to Network Sites owned by the Borrower
for less than 12 months, the sum of (A) Consolidated  EBITDA for each full month
the  Network  Site was owned by the  Borrower  for  which the Bank has  received
financial statements,  plus (B) pro forma Consolidated EBITDA for that number of
months immediately prior to the Borrower's  acquisition equal to 12 months minus
the number of months the Network Site was owned by the Borrower as calculated by
the Borrower in good faith and in a manner reasonably  satisfactory to the Bank,
plus (C) any adjustments reasonably satisfactory to the Bank.

         "Consolidated  Debt Service" shall mean for any period,  the sum of (i)
Consolidated Interest Expense for such period and (ii) all scheduled payments of
principal on  Consolidated  Funded Debt during such period,  including  payments
made on account of Capitalized Leases.

         "Consolidated  EBITDA" shall mean, with respect to the Borrower and its
Subsidiaries for any period,  the sum of (i) Adjusted Net Income,  (ii) Interest
Expense,  (iii)  depreciation,  amortization and other non-cash charges and (iv)
provision  for  Federal,  state  and  local  income  taxes,  in each case of the
Borrower and its Subsidiaries on a consolidated basis for such period,  computed
in accordance with GAAP.

         "Consolidated   Effective   Net  Worth"  shall  mean  at  any  date  of
determination,  the sum of  capital  surplus,  earned  surplus  (or  accumulated
deficit),  the par value of each class of capital stock multiplied by the number
of outstanding shares of such class of capital stock, additional paid-in capital
and  Subordinated  Debt of the Borrower and its  Subsidiaries  on a Consolidated
basis.

         "Consolidated Funded Debt" shall mean at any date of determination, the
aggregate  funded  indebtedness  (as determined in accordance  with GAAP) of the
Borrower and its Subsidiaries,  determined on a Consolidated basis in accordance
with GAAP, on such date.

         "Consolidated  Interest  Expense"  shall  mean,  with  respect  to  the
Borrower  and  its  Subsidiaries  for the  applicable  period  of  determination
thereof,  the interest expense of the Borrower and its Subsidiaries  during such
period determined on a consolidated basis in accordance with GAAP.

         "Consolidated   Senior   Funded   Debt"  shall  mean  at  any  date  of
determination,  the aggregate funded  indebtedness of the Borrower that does not
constitute  Subordinated Debt,  determined on a Consolidated basis in accordance
with GAAP, on such date.

         "Consolidating"  or  "consolidating"  shall mean the  Borrower  and its
Subsidiaries each taken separately.

                                       5


         "Continuation/Conversion Notice" is defined in Section 2.9.

         "Contractual Obligations" shall mean as to any Person, any provision of
any  security  issued  by  such  Person  or  of  any  agreement,  instrument  or
undertaking  to  which  such  Person  is a party  or by  which  it or any of its
property is bound.

         "Controlled" and "Control" shall mean any  partnership,  corporation or
other entity of which the Borrower, alone, or the Borrower and/or one or more of
its Subsidiaries,  either has the power to direct the management or the power to
direct at least a majority of the voting interests.

         "Cost of Funds" means the per annum rate of interest  which the Bank is
required to pay, or is offering to pay, for wholesale liabilities,  adjusted for
reserve  requirements and such other  requirements as may be imposed by federal,
state or local government and regulatory agencies, as determined by the Bank.

         "Default"  shall mean any of the  events  specified  in this  Agreement
under  "Events of  Default",  whether or not any  requirement  for the giving of
notice, the lapse of time, or both, has been satisfied.

         "Dollars"  and "$" shall mean dollars in lawful  currency of the United
States of America.

         "Eligible  Accounts  Receivable  shall mean those Accounts (i) which do
not remain unpaid for more than 90 days from the original  date of invoice,  and
(ii) have been validly assigned to the Bank and, are subject to a first priority
Lien in  favor  of the  Bank  and  comply  with  all of the  terms,  conditions,
warranties  and  representations  made to the Bank under this  Agreement and the
other Loan Documents;  but Eligible  Accounts  Receivable  shall not include the
following:  (a) Accounts with respect to which the Account Debtor is an officer,
director,  employee,  or agent of the  Borrower or an  Affiliate;  (b)  Accounts
arising  from a sale of goods  which are  placed on  consignment,  or subject to
guaranteed sale,  bill-and-hold,  repurchase or return, or other terms by reason
of which the  payment of the Account  Debtor may be  conditional;  (c)  Accounts
arising from invoices for deposits,  and rebills of amounts previously  credited
to the  extent of  credits  issued  more than  fifteen  (15) days  prior to such
rebill;  (d) Accounts with respect to which the Account  Debtor is not domiciled
in the  United  States of America  unless  such  Account is fully  secured by an
irrevocable  letter of credit acceptable to the Bank and in favor of or assigned
to the Bank;  (e) Accounts  with respect to which the sale is on an  installment
sale,  lease or other extended payment basis; (f) Accounts with respect to which
the Account Debtor is a federal,  state, local or foreign governmental authority
unless  such  governmental  authority  is the  United  States of  America or any
department,  agency or  instrumentality  of the Untied States,  and the Borrower
complies  with the  Assignment  of Claims  Act of 1940,  as  amended  (31 U.S.C.
Section 203 et seq.;  (g) Accounts with respect to which the Account Debtor is a
Subsidiary  of,  Affiliate  of, or has common  officers  or  directors  with the
Borrower;  (h)  Accounts  with respect to which the Bank does not for any reason
have a perfected  first  priority  Lien;  (i) Accounts with respect to which the
Borrower  is or may  become  liable to the  Account  Debtor  for  goods  sold or
services  rendered by the Account  Debtor to the Borrower,  to the extent of the
Borrower's  existing or potential liability to such Account Debtor; (j) Accounts
with  respect to which the Account  Debtor has disputed  any  liability,  or the
Account  is  otherwise  subject  to any right of  setoff,  deduction,  breach of
warranty or other  defense,  dispute or  counterclaim  by the Account Debtor but
such Account shall be ineligible only to the extent of the disputed or otherwise
disallowed  amount;  (k) that  portion of any Accounts  representing  late fees,
service  charges  or  interest,  but only to the  extent  of such  portion;  (l)
Accounts of an Account  Debtor where the Account Debtor is located in New Jersey
or Minnesota  unless the Borrower (1) with respect to such state, has received a
Certificate  of Authority to do business and is in good  standing in such state,
or (2) has filed a Notice of  Business  Activities  Report  with the New  Jersey
Division of Taxation or the Minnesota Department of Revenue, as applicable,  for
the  then  current  year;  (m)  Accounts  owed by any  Account  Debtor  which is
insolvent or is the subject of an insolvency proceeding; (n) that portion or any
Accounts  represented  by an instrument,  or chattel paper;  and (o) any and all
Accounts of an Account Debtor whose  creditworthiness is not satisfactory to the
Bank in its reasonable  credit  judgment  based on information  available to the
Bank.  References to  percentages  of all Accounts are based on dollar amount of
Accounts, and not number of Accounts.

                                       6


         "Environmental Laws" shall mean any federal,  state or local statute or
regulation  relating to hazardous or toxic wastes or  substances  or the removal
thereof.

         "ERISA" shall mean the Employee Retirement Income Security Act of 1974,
as amended from time to time.

         "Event of  Default"  shall  mean any of the  events  specified  in this
Agreement  under  "Events of Default",  provided  that any  requirement  for the
giving of notice,  the lapse of time, or both, or any other condition,  has been
satisfied.

         "Facility A Commitment"  shall mean the  obligation of the Bank to make
Facility  A  Revolving  Credit  Loans to the  Borrower  during  the  Facility  A
Commitment  Period  pursuant to the terms hereof as such Commitment is described
in Section  2.1(a)  hereof and as subject to  reduction in  accordance  with the
terms hereof.

         "Facility A Commitment Period" shall mean the period from and including
the date hereof to and including the Facility A Termination Date or such earlier
date as the Facility A Commitment shall terminate as provided herein.

         "Facility B Commitment"  shall mean the  obligation of the Bank to make
Facility  B  Revolving  Credit  Loans to the  Borrower  during  the  Facility  B
Commitment  Period  pursuant to the terms hereof as such Commitment is described
in Section  2.1(a)  hereof and as subject to  reduction in  accordance  with the
terms hereof.

         "Facility B Commitment Period" shall mean the period from and including
the date hereof to and including the Facility B Termination Date or such earlier
date as the Facility B Commitment shall terminate as provided herein.

         "Facility A Revolving  Credit Loan" shall mean a Loan made  pursuant to
Section 2.1(a) hereof.

         "Facility A Revolving  Credit Note" shall mean the Note  referred to in
Section 2.2(a) hereof.

         "Facility B Revolving  Credit Loan" shall mean a Loan made  pursuant to
Section 2.1(b) hereof.

         "Facility B Revolving  Credit Note" shall mean the Note  referred to in
Section 2.2(b) hereof.

                                       7


         "Facility A Termination Date" shall mean September 11, 2001 or, if such
date is not a Business Day, the Business Day next succeeding such date.

         "Facility B Termination Date" shall mean September 11, 2001 or, if such
date is not a Business Day, the Business Day next succeeding such date.

         "Fixed  Charge  Coverage  Ratio"  shall  be  determined  on  a  rolling
four-quarter  basis and shall mean, for any such four-quarter  period, the ratio
of (A)  Consolidated  Adjusted  EBITDA for such period  minus the sum of Capital
Expenditures  during such period that have not been financed  (excluding amounts
paid in connection with Permitted Acquisitions),  and cash dividends paid during
such period and income  taxes paid during such period to (B)  Consolidated  Debt
Service for such period.

         "Fluctuating  Rate Loans" shall mean Loans hereunder that bear interest
at a rate of interest based upon the Prime Rate plus the Applicable  Margin,  if
any.

         "GAAP" shall mean generally accepted accounting principles applied in a
manner  consistent  with  that  employed  in the  preparation  of the  financial
statements described in Section 3.1.

         "Governmental Authority" shall mean any nation or government, any state
or  other  political  subdivision  thereof,  any  entity  exercising  executive,
legislative,  judicial,  regulatory or administrative functions of or pertaining
to government,  and any corporation or other entity owned or controlled (through
stock or capital ownership or otherwise) by any of the foregoing.

         "Guarantees" shall mean the guarantees to be executed by the Guarantors
substantially in the form of Exhibit F hereto.

         "Guarantors" shall mean each and every present and future Subsidiary of
the Borrower that the Bank in its reasonable discretion deems to be a "material"
Subsidiary of the Borrower.

         "Indebtedness"  shall mean (without  duplication),  with respect to any
Person, (a) all obligations of such Person for borrowed money or with respect to
deposits or advances of any kind, (b) all  obligations of such Person  evidenced
by bonds, debentures, notes or other similar instruments, (c) all obligations of
such Person for the  deferred  purchase  price of property or  services,  except
accrued  expenses  arising in the ordinary course of business,  current accounts
payable  arising in the ordinary  course of business and not overdue beyond such
period as is commercially reasonable for such Person's business,  amounts due to
medical  providers and patient deposits (d) all obligations of such Person under
conditional  sale or other  title  retention  agreements  relating  to  property
purchased  by such  Person,  (e) all  payment  obligations  of such  Person with
respect to interest rate or currency protection agreements , (f) all obligations
of such  Person as an account  party under any letter of credit or in respect of
bankers' acceptances, (g) all obligations of any third party secured by property
or assets of such Person (regardless of whether or not such Person is liable for
repayment of such  obligations),  (h) all  guarantees  of such  Person,  (i) all
Capitalized Lease Obligations of such Person and (j) the redemption price of all
redeemable  preferred  stock of such Person (but not  accrued  dividends  on any
preferred  stock),  but only to the extent that such stock is  redeemable at the
option of the holder or requires  sinking  fund or similar  payments at any time
prior to the Termination Date.

                                       8


         "Installment  Payment  Date"  shall  mean any date on which  all or any
portion of the principal amount of the Term Loan is due and payable.

         "Interest  Period"  shall  mean any  period  during  which a Loan bears
interest at a fixed rate as elected by the Borrower in accordance with the terms
of this Agreement.

         (a) If any Interest  Period would otherwise end on a day which is not a
Business  Day,  that  Interest  Period shall be extended to the next  succeeding
Business  Day  unless  the  result of such  extension  would be to  extend  such
Interest Period into another calendar month, in which event such Interest Period
shall end on the immediately preceding Business Day.

         (b) No Interest Period shall extend beyond a stated Maturity Date.

         (c) No portion of the Term Loan shall be continued as or converted into
a Libor Loan with an Interest Period which extends beyond an Installment Payment
Date if, after giving  effect to the  continuation  or  conversion of such Libor
Loan, the amount payable on any Installment Payment Date would exceed the sum of
(i) the aggregate  principal amount of the outstanding  portion of the Term Loan
constituting  Libor Loans with Interest Periods ending prior to such Installment
Payment  Date  and (ii)  the  aggregate  outstanding  portion  of the Term  Loan
constituting Fluctuating Rate Loans.

         (d) If such Interest  Period  commences on a day for which there exists
no  numerically  corresponding  day in the final month of such Interest  Period,
such Interest Period shall end on the last Business Day of such month.

         "Leverage Ratio" shall mean at any date of determination,  the ratio of
(i) Consolidated  Senior Funded Debt as of such date to (ii) Consolidated EBITDA
for the four fiscal  quarter  period ending on such date or, if such date is not
the last day of a fiscal  quarter,  for the  immediately  preceding  four fiscal
quarter period.

         "LIBOR" shall mean, as applicable to any LIBOR Loan, the rate per annum
(rounded upward, if necessary, to the nearest 1/32 of one percent) as determined
on the basis of the offered rates for deposits in U.S. dollars,  for a period of
time  comparable  to the  interest  period  applicable  to such LIBOR Loan which
appears on the Telerate  page 3750 as of 11:00 a.m.  London time on the day that
is two London  Business  Days  preceding  the first day of the  interest  period
applicable to such LIBOR Loan;  provided,  however,  if the rate described above
does not appear on the Telerate System on any applicable interest  determination
date, the LIBOR rate shall be the rate (rounded  upwards as described  above, if
necessary)  for  deposits  in dollars  for a period  substantially  equal to the
interest  period on the  Reuters  Page "LIBO" (or such other page as may replace
the LIBO Page on that service for the purpose of displaying  such rates),  as of
11:00 a.m.  (London Time), on the day that is two (2) London Business Days prior
to the  beginning  of such  Interest  Period.  If both the  Telerate and Reuters
system are  unavailable,  then the rate for that date will be  determined on the
basis of the offered  rates for  deposits  in U.S.  dollars for a period of time
comparable  to the  interest  period  applicable  to such  LIBOR  Loan which are
offered by four  major  banks in the London  interbank  market at  approximately
11:00  a.m.  London  time,  on the  day  that is two (2)  London  Business  Days
preceding the first day of the interest period  applicable to such LIBOR Loan as
selected  by the Bank.  The  principal  London  office of each of the four major
London banks will be requested to provide a quotation of its U.S. dollar deposit
offered rate. If at least two such  quotations  are provided,  the rate for that
date will be the arithmetic mean of the quotations. If fewer than two quotations
are  provided as  requested,  the rate for that date will be  determined  on the
basis of the rates quoted for loans in U.S.  dollars to leading  European  banks
for a period of time comparable to the interest period  applicable to such LIBOR
Loan  offered by major banks in New York City at  approximately  11:00 a.m.  New
York City time, on the day that its two London Business Days preceding the first
day of such  LIBOR  Loan.  In the event  that Bank is unable to obtain  any such
quotation as provided  above,  it will be deemed that LIBOR  pursuant to a LIBOR
Loan  cannot be  determined.  In the event  that the Board of  Governors  of the
Federal  Reserve System shall impose a Reserve  Percentage with respect to LIBOR
deposits of the Bank then for any period  during which such  Reserve  Percentage
shall apply,  LIBOR shall be equal to the amount  determined above divided by an
amount equal to 1 minus the Reserve Percentage.

                                       9


         "LIBOR  Loans" shall mean Loans  hereunder  that bear  interest for the
Interest Period  applicable  thereto at a rate of interest based upon LIBOR plus
the Applicable Margin.

         "Lien"   shall   mean  any   mortgage,   pledge,   security   interest,
hypothecation,  assignment,  deposit  arrangement,  encumbrance,  or preference,
priority or other security agreement or preferential  arrangement of any kind or
nature whatsoever which has the practical effect of creating a security interest
(including,  without  limitation,  any conditional sale or other title retention
agreement,  any financing lease having substantially the same economic effect as
any of the  foregoing,  and the  filing  of any  financing  statement  under the
Uniform Commercial Code or comparable law of any jurisdiction).

         "Loan" or "Loans"  shall mean any loan made by the Bank to the Borrower
hereunder  whether a Facility A  Revolving  Credit  Loan,  Facility B  Revolving
Credit Loan or the Term Loan.

         "Loan Documents" shall mean this Agreement and each document, agreement
and instrument  executed in connection herewith or pursuant hereto together with
each document,  agreement and  instrument  made by the Borrower or any Guarantor
with or in favor of or owing to the Bank.

         "Management Agreement" shall mean an agreement entered into between the
Borrower and a Practice Group pursuant to which the Borrower provides management
and  administrative  services to such Practice Group and furnishes such Practice
Group with facilities, equipment, personnel and supplies.

         "Maturity  Date"  shall  mean the date  that  all or a  portion  of the
outstanding principal balance of a Loan is due and payable pursuant to the terms
hereof  which shall  include  without  limitation  (i) with respect to Revolving
Credit Loans, the applicable Termination Date, and (ii) with respect to the Term
Loan,  each  Installment  Payment Date and the final  Maturity  Date of the Term
Loan.

         "Network  Site" means each  location  with  respect to which a Practice
Group has entered into a single Management Agreement with the Borrower.

         "Notes" shall mean  collectively  the Facility A Revolving  Credit Note
referred to in Section  2.2(a)  hereof,  the  Facility B  Revolving  Credit Note
referred to in Section  2.2(b)  hereof and the Term Note  referred to in Section
2.8 hereof.

         "Notice of Borrowing" is defined in Section 2.3.

         "Obligations"  shall  mean  any and  all  sums  owing  under  the  Loan
Documents and all other  obligations,  direct or contingent,  joint,  several or
independent,  of the Borrower now or hereafter existing due or to become due to,
or held or to be  held by the  Bank  pursuant  to the  Loan  Documents,  whether
created directly or acquired by assignment or otherwise.

         "Permitted  Acquisition" shall mean an Acquisition permitted by Section
7.2.

         "Person" shall mean any  individual,  corporation,  partnership,  joint
venture,  limited liability company, trust,  unincorporated  organization or any
other  juridical  entity,  or a  government  or state or any agency or political
subdivision thereof.

         "Plan" shall mean any plan of a type  described  in Section  4021(a) of
ERISA in respect of which the  Borrower is an  "employer"  as defined in Section
3(5) of ERISA.

         "Practice  Group"  means  one  or  more  physicians  or a  professional
corporation  or  professional  association  owned by physicians or a hospital or
medical center.

         "Post-Default  Rate" shall mean at any time a rate of interest equal to
4% per annum in excess of the rate that would then be applicable to  Fluctuating
Rate Loans based upon the Pricing Level therefor.

         "Pricing Level" shall mean Pricing Level I, Pricing Level II or Pricing
Level III, as applicable.

         "Pricing Level I" shall mean the  applicable  Pricing Level at any time
when the Leverage Ratio is greater than 1.50:1.00.

                                       10


         "Pricing Level II" shall mean the applicable  Pricing Level at any time
when the  Leverage  Ratio is greater  than  1.00:1.00  but less than or equal to
1.50:1.00.

         "Pricing Level III" shall mean the applicable Pricing Level at any time
when the Leverage Ratio is less than or equal to 1.00:1.00.

         "Prime  Rate"  shall mean the  variable  per annum rate of  interest so
designated  from time to time by the Bank as its prime rate. The Prime Rate is a
reference rate and does not necessarily  represent the lowest or best rate being
charged to any customer.

         "Property" shall mean all types of real, personal, tangible, intangible
or mixed property.

         "Real  Property"  shall mean any real  property  owned or leased by the
Borrower or any of its Subsidiaries or any Guarantor or any of its Subsidiaries.

         "Reportable  Event"  shall  mean any of the events set forth in Section
4043(b) of ERISA or the regulations thereunder.

         "Requirements  of Law" shall mean as to any Person,  the certificate of
incorporation and by-laws or other organizational or governing documents of such
Person,  and  any  law,  treaty,  rule or  regulation,  or  determination  of an
arbitrator or a court or other Governmental  Authority,  in each case applicable
to or binding upon such Person or any of its property or to which such Person or
any of its property is subject.

         "Revolving Credit Loan" shall mean any Facility A Revolving Credit Loan
and/or any Facility B Revolving Credit Loan made pursuant to Section 2.1 hereof.

         "Revolving Credit Note" shall mean any Facility A Revolving Credit Note
and/or any Facility B Revolving Credit Note referred to in Section 2.2. hereof.

         "Security Agreement" shall mean the Security  Agreement(s)  referred to
in this  Agreement,  certain  or all of which are  substantially  in the form of
Exhibit G hereto.

         "Specified  Person"  shall  mean  either  the  Borrower  or  any of its
Subsidiaries or any Guarantor or any of its Subsidiaries.

         "Subordinated  Debt" shall mean all Indebtedness  owing by the Borrower
to any  Person  that  is  completely  subordinated  to  all  of  the  Borrower's
Obligations  to the  Bank  pursuant  to a  subordination  agreement  in form and
substance satisfactory to the Bank.

         "Subsidiary" or "Subsidiaries" of any Person shall mean any corporation
or  corporations  of which the Person alone, or the Person and/or one or more of
its  Subsidiaries,  owns,  directly  or  indirectly,  at least a majority of the
securities having ordinary voting power for the election of directors.

                                       11


         "Term Loan" shall mean the Loan made pursuant to Section 2.8 hereof.

         "Term Note" shall mean the Note referred to in Section 2.8 hereof.

         "Type" refers to whether a Loan is a  Fluctuating  Rate Loan or a Libor
Loan.

         "Year 2000 Issue" shall mean failure of computer software, hardware and
firmware systems and equipment  containing  embedded  computer chips to properly
receive, transmit, process,  manipulate,  store, retrieve,  retransmit or in any
other way utilize data and information due to the occurrence of the year 2000 or
the inclusion of dates on or after January 1, 2000.

         1.2 Accounting  Terms.  As used herein and in any  certificate or other
document made or delivered  pursuant  hereto,  accounting terms not specifically
defined herein shall have the respective  meanings given to them under generally
accepted accounting principles.


2.       AMOUNT AND TERMS OF REVOLVING CREDIT COMMITMENT AND TERM NOTE.

         2.1 Revolving Credit Commitments.

         (a) Subject to the terms and conditions hereof, the Bank agrees to make
revolving credit loans to the Borrower (the "Facility A Revolving Credit Loans")
from  time to time  during  the  Facility  A  Commitment  Period  the  aggregate
principal  amount  of which at any one time  outstanding  shall not  exceed  the
lesser of the  Borrowing  Base or  $4,000,000,  as such amount may be reduced as
provided in this Agreement (the "Facility A Commitment").  During the Facility A
Commitment  Period the Borrower may use the  Commitment  for obtaining  Loans by
borrowing,  prepaying in whole or in part and reborrowing on a revolving  basis,
all in accordance with the terms and conditions hereof.

         (b) Subject to the terms and conditions hereof, the Bank agrees to make
revolving credit loans to the Borrower (the "Facility B Revolving Credit Loans")
from  time to time  during  the  Facility  B  Commitment  Period  the  aggregate
principal  amount  of  which  at any  one  time  outstanding  shall  not  exceed
$5,000,000,  as such amount may be reduced as provided  in this  Agreement  (the
"Facility B Commitment").  During the Facility B Commitment  Period the Borrower
may use the Facility B Commitment for obtaining Loans by borrowing, prepaying in
whole or in part and  reborrowing on a revolving  basis,  all in accordance with
the terms and conditions hereof.

         2.2 Revolving Credit Notes.

         (a) The  Facility  A  Revolving  Credit  Loans  made by the Bank to the
Borrower  pursuant to Section  2.1(a)  hereof shall be evidenced by a promissory
note  of the  Borrower  substantially  in the  form of  Exhibit  A  hereto  with
appropriate  insertions (the "Facility A Revolving Credit Note"), payable to the
order of the Bank and  representing  the  obligation  of the Borrower to pay the
lesser of (a) the amount of the  Facility  A  Commitment  or, (b) the  aggregate
unpaid  principal  amount of all  Facility A Revolving  Credit Loans made by the
Bank to the  Borrower,  with interest  thereon as  hereinafter  prescribed.  The
Facility A  Revolving  Credit Note shall (i) be dated the date  hereof,  (ii) be
stated to mature on the Facility A Termination Date and (iii) bear interest with
respect to the unpaid principal balance thereof from time to time outstanding at
a rate per annum to be elected by the  Borrower  in  accordance  with the notice
provisions  set forth in Section 2.3 hereof,  and in the case of LIBOR Loans for
the  Interest  Period  therein  specified,  equal to either  (1) LIBOR  plus the
Applicable  Margin,  or (2) the Prime  Rate plus the  Applicable  Margin  (which
interest  rate will  change  when and as the Prime Rate  changes).  In all cases
interest  shall be  computed  on the basis of a  360-day  year for  actual  days
elapsed and shall be payable as provided in this Agreement.  After any stated or
accelerated  maturity,  the Facility A Revolving Credit Note shall bear interest
at the rate set forth in this Agreement.

                                       12


         (b) The  Facility  B  Revolving  Credit  Loans  made by the Bank to the
Borrower  pursuant to Section  2.1(b)  hereof shall be evidenced by a promissory
note  of the  Borrower  substantially  in the  form of  Exhibit  B  hereto  with
appropriate  insertions (the "Facility B Revolving Credit Note"), payable to the
order of the Bank and  representing  the  obligation  of the Borrower to pay the
lesser of (a) the amount of the  Facility  B  Commitment  or, (b) the  aggregate
unpaid  principal  amount of all  Facility B Revolving  Credit Loans made by the
Bank to the  Borrower,  with interest  thereon as  hereinafter  prescribed.  The
Facility B  Revolving  Credit Note shall (i) be dated the date  hereof,  (ii) be
stated to mature on the Facility B Termination Date and (iii) bear interest with
respect to the unpaid principal balance thereof from time to time outstanding at
a rate per annum to be elected by the  Borrower  in  accordance  with the notice
provisions  set forth in Section 2.3 hereof,  and in the case of LIBOR Loans for
the  Interest  Period  therein  specified,  equal to either  (1) LIBOR  plus the
Applicable  Margin,  or (2) the Prime  Rate plus the  Applicable  Margin  (which
interest  rate will  change  when and as the Prime Rate  changes).  In all cases
interest  shall be  computed  on the basis of a  360-day  year for  actual  days
elapsed and shall be payable as provided in this Agreement.  After any stated or
accelerated  maturity,  the Facility B Revolving Credit Note shall bear interest
at the rate set forth in this Agreement.

         2.3  Procedure  for  Borrowings.  The  Borrower  may  borrow  under the
applicable  Commitment  during the applicable  Commitment Period on any Business
Day by giving the Bank  irrevocable  notice (each a "Notice of  Borrowing") of a
request  for a Facility A  Revolving  Credit  Loan and/or a Facility B Revolving
Credit Loan  hereunder (a) in the case of LIBOR Loans three Business Days before
a proposed  borrowing or  continuation  or conversion and (b) in the case of all
other Loans not less than one nor more than five Business Days before a proposed
borrowing or  continuation  or  conversion,  setting forth (i) the amount of the
Loan  requested,  which  shall not be less  than  $100,000,  (ii) the  requested
borrowing date or Interest Period  commencement  date, as the case may be, (iii)
whether the Loan shall be a LIBOR Loan,  Fluctuating  Rate Loan or a combination
thereof,  and (iv) if  entirely or  partially  a LIBOR  Loan,  the length of the
Interest Period therefor,  which shall be one, two, three or six months,  as the
Borrower shall elect. As used in this Section 2.3,  "conversion"  shall mean the
conversion  of a Loan from one Type to another  Type as more fully  described in
this Agreement. Such notice shall be written (including, without limitation, via
facsimile  transmission)  and shall be  sufficient  if received by l p.m. on the
date on  which  such  notice  is to be  given.  If any such  request  is sent by
facsimile  it shall be  confirmed  in writing  sent by the  Borrower to the Bank
within two Business Days thereafter.  Unless notification is otherwise furnished
by the Borrower to the Bank (in a manner  consistent  with the  requirements  of
this Section),  Loans will be made by credits to the  Borrower's  demand deposit
account  maintained with the Bank. If the Borrower  furnishes such notice but no
election is made as to the Type of Loan or the Interest  Period to be applicable
thereto,  the Loan will  automatically  then be made as a Fluctuating  Rate Loan
until such required information is furnished pursuant to the terms hereof.

         2.4 [Reserved].

         2.5 Commitment Fees.

         (a) As  additional  compensation  for the Facility A Commitment  on the
revolving  basis  provided  for herein,  the  Borrower  agrees to pay the Bank a
commitment  fee for the  Facility  A  Commitment  Period at the rate of .25% per
annum  on the  average  daily  unused  portion  of  the  Facility  A  Commitment
hereunder.  Such commitment fee shall be payable  quarterly,  on the last day of
each March, June September and December during the Facility A Commitment Period,
commencing  September 30, 1998,  and on the Facility A Termination  Date. If the
Borrower  fails to pay any such  amount to the Bank when due the  amount of such
defaulted  payment  shall  bear  interest  from the date  when  due  until  (but
excluding) the date when paid at the Post-Default Rate. The obligation so to pay
interest  shall  not be  construed  so as to waive  the  requirement  to pay the
commitment fees as hereinabove set forth.

         (b) As  additional  compensation  for the Facility B Commitment  on the
revolving  basis  provided  for herein,  the  Borrower  agrees to pay the Bank a
commitment  fee for the  Facility  B  Commitment  Period at the rate of .20% per
annum  on the  average  daily  unused  portion  of  the  Facility  B  Commitment
hereunder.  Such commitment fee shall be payable  quarterly,  on the last day of
each March, June September and December during the Facility B Commitment Period,
commencing  September 30, 1998,  and on the Facility B Termination  Date. If the
Borrower  fails to pay any such  amount to the Bank when due the  amount of such
defaulted  payment  shall  bear  interest  from the date  when  due  until  (but
excluding) the date when paid at the Post-Default Rate. The obligation so to pay
interest  shall  not be  construed  so as to waive  the  requirement  to pay the
commitment fees as hereinabove set forth.

                                       13


         2.6  Regulatory  Changes in Capital  Requirements.  If as a result of a
change in any  existing,  or the  imposition of any future,  law,  regulation or
guideline  or the  interpretation  thereof  by any  court or  administrative  or
governmental authority charged with the administration thereof, or compliance by
the Bank with any request or directive  (whether or not having the force of law)
of any such authority,  imposes,  modifies,  deems  applicable or results in the
application of, any capital  maintenance,  capital ratio or similar  requirement
against loan  commitments  made by the Bank (or  participations  therein) or the
Bank in anticipation of the  effectiveness of any capital  maintenance,  capital
ratio or similar  requirement takes reasonable action to enable itself to comply
therewith,  and the result  thereof is to impose upon the Bank or  increase  any
capital  requirement  applicable  as a result of the  making or  maintenance  of
either or both  Commitments or  participations  therein (which  imposition of or
increase in capital  requirements  may be  determined  by the Bank's  reasonable
allocation of the aggregate of such capital impositions or increases) then, upon
demand by the Bank, the Borrower shall  immediately pay to the Bank from time to
time as specified by the Bank such  additional  amount as shall be sufficient to
compensate   the  Bank  for  such   impositions   of  or  increases  in  capital
requirements.  Any such amount not paid  within one  Business  Day after  demand
being made by the Bank shall be paid together with interest at the  Post-Default
Rate from the date demanded until payment in full thereof. A certificate setting
forth in reasonable  detail the amounts  necessary to  compensate  the Bank as a
result of an imposition of or increase in capital requirements  submitted by the
Bank to the Borrower shall be conclusive, absent manifest error or bad faith, as
to the amount  thereof.  For purposes of this  Section,  all  references  to the
"Bank" shall be deemed to include any corporation controlling the Bank. The Bank
will  promptly  notify  the  Borrower  of any  event of  which it has  knowledge
occurring after the date hereof which will entitle it to  compensation  pursuant
to  this  Section  and  will  designate  a  different  lending  office  if  such
designation  will  avoid  the need  for,  or  reduce  the  amount  of,  any such
additional amounts which may thereafter accrue and would not, in the judgment of
the Bank, be otherwise disadvantageous to the Bank.

         2.7 Termination or Reduction of Commitment. The Borrower shall have the
right,  upon not less than three Business Days'  irrevocable  written notice, to
terminate either  Commitment or, from time to time, to reduce the amount of such
Commitment,  provided  that (a) any such  reduction  (i) shall be in the minimum
amount of $500,000 or an integral  multiple of $100,000 in excess thereof,  (ii)
shall reduce permanently the amount of such Commitment then in effect, and (iii)
shall be  accompanied  by prepayment of the  applicable  Revolving  Credit Loans
outstanding to the extent,  if any, that the Loans then  outstanding  exceed the
amount of such Commitment as then reduced, together with accrued interest on the
amount so prepaid to and  including  the dates of each such  prepayment  and any
amounts payable pursuant to Section 2.14 in connection therewith and the payment
of any  unpaid  commitment  fee  applicable  to  such  commitment  then  accrued
hereunder,  and (b) any such termination of such Commitment shall be accompanied
by prepayment in full of the  applicable  Revolving  Credit Loans  together with
accrued interest thereon to and including the date of prepayment and any amounts
payable pursuant to Section 2.14 in connection  therewith and the payment of any
unpaid commitment fee applicable to such commitment then accrued hereunder.

         2.8 Term Loan.  The Bank  hereby  agrees to make a 66-month  $4,000,000
term loan (the "Term  Loan") to the  Borrower.  The Term Loan shall be made as a
Fluctuating  Rate Loan  unless  and until the  Borrower  furnishes  the  notices
required by this Agreement to convert all or a portion of such Loan to a Loan of
another  Type.  The Term Loan shall be  evidenced  by a  promissory  note of the
Borrower  substantially  in the  form  of  Exhibit  C  hereto  with  appropriate
insertions (the "Term Note") and dated the date of such Term Loan. The principal
amount of the Term Note shall be payable in sixteen (16)  consecutive  quarterly
installments  each of which  shall be in an amount  equal to Two  Hundred  Fifty
Thousand  Dollars  and  00/100  ($250,000.00),  payable on the first day of each
January,  March,  June and  September  commencing  June 1, 2000 until the entire
unpaid  principal  balance of the Term Note shall be paid in full. The Term Note
shall bear  interest on the unpaid  principal  amount  thereof from time to time
outstanding  at a rate per annum,  to be elected  pursuant to the  provisions of
this Agreement equal to either (i) LIBOR plus the Applicable Margin, or (ii) the
Prime Rate plus the Applicable Margin (which interest rate shall change when and
as the Prime Rate changes). In all cases interest shall be computed on the basis
of a 360-day  year for actual  days  elapsed and shall be payable as provided in
this Agreement.  After any stated or accelerated maturity thereof, the Term Note
shall bear interest at the increased rate set forth in this Agreement.


                                       14


         2.9  Continuation  and Conversion of Loans. The Borrower shall have the
right at any time on prior  irrevocable  written or telex  notice to the Bank as
specified in this  Agreement  (i) to continue any LIBOR Loan as a Libor Loan for
the same or a different  Interest  Period  (specifying the Interest Period to be
applicable thereto), (ii) to convert any LIBOR Loan into a Fluctuating Rate Loan
and (iii) to convert any Fluctuating Rate Loan into a LIBOR Loan (specifying the
Interest   Period   to   be   applicable   thereto)   (each   such   notice,   a
"Continuation/Conversion Notice"), subject to the following:

         (a) in the case of a  conversion  of less  than all of the  outstanding
Loans, the aggregate  principal amount of Loans converted shall not be less than
$100,000 and shall be an integral multiple thereof;

         (b) no LIBOR Loan shall be  converted at any time other than at the end
of an Interest Period applicable thereto; and

         (c) any  portion of a Loan  maturing  or required to be prepaid in less
than one month may not be converted into or continued as a LIBOR Loan.

         In the event that the  Borrower  shall not give notice to continue  any
LIBOR Loan into a  subsequent  Interest  Period or convert  any such Loan into a
Loan of another type, on the last day of the Interest Period thereof,  such Loan
(unless prepaid) shall  automatically be converted into a Fluctuating Rate Loan.
The Interest Period  applicable to any Libor Loan resulting from a conversion or
continuation  shall be  specified  by the  Borrower  in the  irrevocable  notice
delivered by the Borrower pursuant to this Agreement;  provided,  however, that,
if such notice does not specify  either the type of Loan or the Interest  Period
to be applicable  thereto,  the Loan shall  automatically  be converted into, or
continued  as, as the case may be, a  Fluctuating  Rate Loan until such required
information is furnished pursuant to the terms hereof.  Notwithstanding anything
to the contrary  contained above, if an Event of Default shall have occurred and
is continuing,  no Libor Loan may be continued into a subsequent Interest Period
and no Fluctuating Rate Loan may be converted into a Libor Loan.

         2.10 Prepayment.

         (a)  Voluntary.  The Borrower may prepay any  Fluctuating  Rate Loan in
whole or in part  without  premium  or  penalty;  provided,  however,  that each
partial prepayment on account of any Fluctuating Rate Loan shall be in an amount
not less than  $100,000 or an integral  multiple of $100,000 in excess  thereof.
Except as provided otherwise in this Agreement,  the Borrower may not prepay any
Libor Loan prior to the last day of the  Interest  Period  therefor.  Any amount
prepaid on account of a Revolving  Credit Loan may be  reborrowed  in accordance
with the  provisions of Section 2.1 hereof.  Any partial  prepayment of the Term
Loan shall be applied to the last maturing installments thereof in inverse order
of their respective maturities.

                                       15


         (b)  Mandatory.  If, at any time, the aggregate  outstanding  principal
balance of Facility A Revolving  Credit  Loan(s)  exceeds  the  Borrowing  Base,
within five days of the first day there exists such excess,  the Borrower  shall
make  payment to the Bank in an amount  equal to such excess  together  with any
amounts payable pursuant to Section 2.14 in connection  therewith.  Such payment
shall be applied to reduce the aggregate unpaid principal  balance of Facility A
Revolving Credit Loans then outstanding by first applying such payment to reduce
Fluctuating  Rate  Loans and then to reduce  LIBOR  Loans.  Notwithstanding  the
foregoing,  the  Borrower  may  direct  by  written  notice to the Bank that any
prepayment or repayment be applied first, to the principal amount of LIBOR Loans
if such  prepayment or repayment is made on the last day of the Interest  Period
applicable thereto.

         Each prepayment shall be made together with payment of accrued interest
on the amount prepaid to and including the date of prepayment.

         2.11  Interest  Payments;  Manner  of  Payments;  Rate  After  Default;
Schedule to Note.

         (a)   Interest   accrued  on  each  Loan  shall  be  payable,   without
duplication, on:

                (i) the Maturity Date of such Loan  (excluding  any  Installment
Payment Date unless  interest  would  otherwise  be payable on such  Installment
Payment Date pursuant to subsections (ii) - (v) below);

                (ii) with  respect to any  portion of any Loan repaid or prepaid
pursuant to this  Agreement,  the date of such repayment or  prepayment,  as the
case may be;

                (iii) with respect to that portion of the outstanding  principal
amount of all Loans  maintained as Fluctuating Rate Loans, the first day of each
month  commencing  with the first such date  following the date of the making of
such Loans;

                (iv) with respect to that portion of the  outstanding  principal
amount  maintained  as LIBOR  Loans,  the last day of each  applicable  Interest
Period (and, if such Interest Period shall exceed three months,  on the last day
of each three-month  period occurring  during such Interest  Period),  but in no
event more frequently than monthly;

                (v) with  respect to that portion of the  outstanding  principal
amount  converted  into  Fluctuating  Rate  Loans or  Libor  Loans on a day when
interest would not otherwise have been payable pursuant to Subsections  (a)(iii)
or (a)(iv), the date of such conversion.

         (b) All payments (including  prepayments) to be made by the Borrower on
account of principal or interest  with respect to any Loan or on account of fees
or any other  obligations of the Borrower to the Bank hereunder shall be made to
the Bank at the office of the Bank set forth in Section  10.1  hereof or at such
other  place as the Bank may from time to time  designate  in  writing in lawful
money of the United States of America in  immediately  available  funds.  If the
entire  amount of any  required  principal  and/or  interest is not paid in full
within ten (10) days after the same is due, the Borrower shall pay to the Bank a
late fee equal to five percent (5%) of the required payment. The Borrower hereby
authorizes and directs the Bank to charge any account of the Borrower maintained
at any office of the Bank for any such  payments.  Subject to the  provisions of
subparagraph  (a) in the definition of Interest  Period set forth in Section 1.1
hereof, if any payment to be so made hereunder,  or under any Note,  becomes due
and payable on a day other than a Business  Day,  such payment shall be extended
to the next succeeding  Business Day and, to the extent  permitted by applicable
law,  interest  thereon shall be payable at the then applicable rate during such
extension.

                                       16


         (c) Upon and following an Event of Default,  all Loans, and any and all
accrued  and unpaid  interest,  fees or  amounts  due  hereunder,  to the extent
permitted by applicable law, shall bear interest (payable on demand,  and in any
event  on the last  day of each  month,  and  computed  daily on the  basis of a
360-day year for actual days elapsed) (i) in all cases other than Libor Loans at
the  Post-Default  Rate until paid and (ii) in the case of Libor Loans at a rate
which shall be the greater of the Post-Default Rate or 4% per annum in excess of
the rate  applicable to such Libor Loan (based upon the Pricing Level  therefor)
until the  expiration of the Interest  Period  applicable to such Loan, at which
time the Loan will  automatically  be converted into a Fluctuating Rate Loan and
until paid shall bear interest at the Post-Default  Rate. In no event,  however,
shall  interest  payable  hereunder be in excess of the maximum rate of interest
permitted  under  applicable  law. The  obligation  so to pay interest  upon any
obligation of the Borrower to the Bank shall not be construed so as to waive the
requirement for payment on the date that payment is due to the Bank as set forth
in this Agreement.

         (d) The Borrower hereby expressly  authorizes the Bank to record on the
schedule  attached  to each  Revolving  Credit  Note the amount and date of each
Revolving Credit Loan, the rate of interest thereon, the date and amount of each
payment of principal and the unpaid principal balance;  provided,  however, that
the failure of the Bank to make any such notation shall not in any manner affect
the  obligation of the Borrower to repay any Loan in  accordance  with the terms
hereof. All such notations shall be presumed to be correct.

         2.12 Use of Proceeds.

         (a) The proceeds of Facility A Revolving  Credit Loans shall be used to
finance working capital requirements of the Borrower.

         (b) The proceeds of Facility B Revolving  Credit Loans shall be used by
the Borrower for Acquisitions within the limitations of this Agreement.

         (c) The proceeds of the Term Loan hereunder  shall be used to refinance
existing  Indebtedness of the Borrower owing to First Union National Bank and to
finance  a portion  of the costs  associated  with the  Borrower's  Acquisitions
within the limitations of this Agreement.

         2.13 Increased  Costs.  If the Bank  determines  that the effect of any
applicable   law  or   government   regulation,   guideline   or  order  or  the
interpretation   thereof  by  any  Governmental   Authority   charged  with  the
administration  thereof  (such as, for  example,  a change in  official  reserve
requirements  which the Bank is  required  to  maintain  in  respect of loans or
deposits or other funds procured for funding such loans) is to increase the cost
to the Bank of making or  continuing  Libor  Loans  hereunder  or to reduce  the
amount of any payment of principal or interest  receivable  by the Bank thereon,
then the Borrower will pay to the Bank on demand such additional  amounts as the
Bank may  determine to be required to  compensate  the Bank for such  additional
costs or reduction.  Any additional  payment under this section will be computed
from the effective date at which such  additional  costs have to be borne by the
Bank.  A  certificate  as to any  additional  amounts  payable  pursuant to this
Section setting forth the basis and method of determining  such amounts shall be
conclusive, absent manifest error, as to the determination by the Bank set forth
therein if made reasonably and in good faith. The Borrower shall pay any amounts
so  certified  to it by  the  Bank  within  10  days  of  receipt  of  any  such
certificate. The Bank will promptly notify the Borrower of any event of which it
has  knowledge  occurring  after  the  date  hereof  which  will  entitle  it to
compensation  pursuant to this  Section and will  designate a different  lending
office if such designation will avoid the need for, or reduce the amount of, any
such  additional  amounts  which may  thereafter  accrue and would  not,  in the
judgment of the Bank, be otherwise  disadvantageous to the Bank. For purposes of
this  Section,  all  references  to the "Bank"  shall be deemed to  include  any
participant in any Commitment and/or Loans.

                                       17


         2.14 Yield  Maintenance.  If, at any time (i) any Loan is a Libor Loan,
and (ii) the Bank in its sole  discretion  should  determine that current market
conditions  can  accommodate a prepayment  request,  the Borrower shall have the
right at such time and from time to time to prepay  such Loan in whole  (but not
in part),  and the Borrower shall pay to the Bank a yield  maintenance fee in an
amount  computed  as  follows:  The  current  rate for  United  States  Treasury
securities (bills on a discounted basis shall be converted to a bond equivalent)
with a maturity date closest to the maturity date of the term chosen pursuant to
the Fixed Rate Election as to which the prepayment is made,  shall be subtracted
from the Cost of Funds  component  of the  fixed  rate in  effect at the time of
prepayment.  If the result is zero or a negative number, there shall be no yield
maintenance  fee.  If the  result  is a  positive  number,  then  the  resulting
percentage  shall be  multiplied  by the amount of the  principal  balance being
prepaid.  The  resulting  amount shall be divided by 360 and  multiplied  by the
number of days remaining in the term chosen  pursuant to the Fixed Rate Election
as to which the  prepayment  is made.  Said  amount  shall be reduced to present
value  calculated by using the number of days remaining in the  designated  term
and using the  above-referenced  United  States  Treasury  security rate and the
number of days remaining in the term chosen  pursuant to the Fixed Rate Election
as to which the  prepayment  is made.  The  resulting  amount shall be the yield
maintenance  fee  due to the  Bank  upon  prepayment  of the  Libor  Loan.  Each
reference in this paragraph to "Fixed Rate Election"  shall mean the election by
the Borrower pursuant to Section 2.3 of this Agreement.

         If by reason of an Event of Default the Bank elects to declare any Loan
to be  immediately  due and payable,  then the foregoing  amount with respect to
such Loan shall become due and payable in the same manner as though the Borrower
had exercised such right of prepayment.

         A certificate as to any  additional  amounts  payable  pursuant to this
Section setting forth the basis and method of determining  such amounts shall be
conclusive, absent manifest error, as to the determination by the Bank set forth
therein if made reasonably and in good faith. The Borrower shall pay any amounts
so  certified  to it by  the  Bank  within  10  days  of  receipt  of  any  such
certificate. For purposes of this Section, all references to the "Bank" shall be
deemed to include any participant in any Commitment and/or Loans.

         2.15  Alternate Rate of Interest.  In the event,  and on each occasion,
that on the day two  Business  Days prior to the  commencement  of any  Interest
Period for a LIBOR Loan, the Bank shall have determined (i) that dollar deposits
in the  amount of the  requested  principal  amount of such  LIBOR  Loan are not
generally  available in the London Interbank Market, (ii) that the rate at which
such dollar  deposits are being offered will not  adequately  and fairly reflect
the cost to the Bank of  making or  maintaining  such  LIBOR  Loan  during  such
Interest  Period,  or (iii) that reasonable  means do not exist for ascertaining
the LIBOR,  the Bank shall, as soon as practicable  thereafter,  give written or
telex notice of such  determination  to the  Borrower.  In the event of any such
determination,  until the  circumstances  giving  rise to such  notice no longer
exist,  (i) no LIBOR Loans will be made  hereunder (ii) each  outstanding  LIBOR
Loan shall be converted into a Fluctuating Rate Loan on the last day of the then
current  Interest  Period  applicable  thereto  and (iii)  unless  the  Borrower
notifies the Bank at least two  Business  Days prior to the date of any proposed
borrowing of a LIBOR Loan for which a Notice of Borrowing  has  previously  been
given that it elects not to borrow on such date, such Loan shall instead be made
as a Fluctuating Rate Loan.

         Promptly upon becoming aware that the circumstances giving rise to such
notice no  longer  exist,  the Bank  shall use its best  efforts  to notify  the
Borrower  that its  obligation  to make LIBOR Loans and convert Loans into LIBOR
Loans has been reinstated, but its failure to do so shall impose no liability on
the Bank. Each  determination  by the Bank hereunder shall be conclusive  absent
manifest error.

                                       18


         2.16 Change in Legality.

         (a) Notwithstanding  anything to the contrary herein contained,  if any
change  in  any  law  or  regulation  or in the  interpretation  thereof  by any
governmental authority charged with the administration or interpretation thereof
shall make it unlawful for the Bank to make or maintain any LIBOR Loan, then, by
written notice to the Borrower, the Bank may:

                (i) declare that LIBOR Loans will not  thereafter be made by the
Bank hereunder, whereupon the Borrower shall be prohibited from requesting LIBOR
Loans from the Bank hereunder unless such declaration is subsequently withdrawn;
and

                (ii)  require  that all  outstanding  LIBOR  Loans made by it be
converted  to  Fluctuating  Rate Loans,  in which event (x) all such LIBOR Loans
shall be  automatically  converted to Fluctuating Rate Loans as of the effective
date of such notice as provided in paragraph  (b) below and (y) all payments and
prepayments  of principal  which would  otherwise have been applied to repay the
converted  LIBOR Loans shall  instead be applied to repay the  Fluctuating  Rate
Loans resulting from the conversion of such LIBOR Loans.

         (b) For purposes of this Section,  a notice to the Borrower by the Bank
pursuant to paragraph  (a) above shall be  effective  with respect to each LIBOR
Loan, if lawful,  on the last day of the then current  Interest  Period for such
LIBOR Loan;  in all other  cases,  such notice  shall be effective on the day of
receipt by the Borrower and (ii) all references to the "Bank" shall be deemed to
include any participant in any Commitment and/or the Loans.

         Promptly upon becoming aware that the circumstances giving rise to such
notice no  longer  exist,  the Bank  shall use its best  efforts  to notify  the
borrower  that its  obligation  to make LIBOR Loans and convert Loans into LIBOR
Loans has been reinstated, but its failure to do so shall impose no liability on
the Bank.


3.       REPRESENTATIONS AND WARRANTIES.

         In order to induce  the Bank to enter into this  Agreement  and to make
the financial accommodations herein provided for, the Borrower hereby covenants,
represents and warrants to the Bank that:

         3.1 Financial Condition. The consolidated balance sheet of the Borrower
and the  Guarantors  as at  December  31,  1997,  and the  related  consolidated
statements  of  operations  and retained  earnings and cash flows for the fiscal
year  ended on such  date,  certified  by Price  Waterhouse  LLP copies of which
certified  statements  have  heretofore been furnished to the Bank, are complete
and correct and present fairly the financial  condition of the Borrower and each
such Guarantor as at such date, and the results of its operations and changes in
financial  position  for the fiscal year then ended.  Such  certified  financial
statements,  including  schedules  and  notes  thereto,  have been  prepared  in
accordance with generally accepted accounting  principles.  Neither the Borrower
nor  any  Guarantor  has  any  material   contingent   obligations,   contingent
liabilities or liabilities  for taxes,  long-term  leases or unusual  forward or
long-term  commitments,  which  are not  reflected  in the  foregoing  certified
statements  or in the  notes  thereto.  Except  as set  forth  in the  Company's
Quarterly  Reports on Form 10-Q for the  quarters  ended March 31, 1998 and June
30,  1998,  respectively,   since  the  date  of  the  aforementioned  financial
statements,   there  has  been  no  material  adverse  change  in  the  business
operations,  assets or  financial  or other  condition  of the  Borrower  or any
Guarantor.

                                       19


         3.2  Corporate  Existence;  Compliance  with Law.  The  Borrower,  each
Guarantor and each of their Subsidiaries (a) is duly organized, validly existing
and in good standing under the laws of the  jurisdiction  of its  incorporation,
(b) has the corporate power and authority and the legal right to own and operate
its property,  and to conduct the business in which it is currently engaged, (c)
is duly qualified as a foreign  corporation  and in good standing under the laws
of each jurisdiction where its ownership or operation of property or the conduct
of its business  require such  qualification,  and (d) is in compliance with all
Requirements  of Law;  except to the extent  that the failure to so qualify as a
foreign  corporation as required by clause (c) of this Section or to comply with
all  Requirements of Law as required by clause (d) of this Section could not, in
the  aggregate,  have a material  adverse  effect on the  business,  operations,
property or  financial  or other  condition  of any such  Person,  and could not
materially  adversely  affect the  ability of (i) the  Borrower  to perform  its
obligations under this Agreement,  the Notes and its Security  Agreement or (ii)
any  Guarantor  to perform its  obligations  under its  Guarantee  and  Security
Agreement, if any.

         3.3  Corporate  Power;  Authorization;   Enforceable  Obligations.  The
Borrower  has the  corporate  power and  authority  and the legal right to make,
execute,  deliver and perform its obligations under this Agreement, its Security
Agreement  and the Notes,  and to borrow  hereunder  and has taken all necessary
corporate action to authorize the borrowings on the terms and conditions of this
Agreement,  its Security Agreement and the Notes and to authorize the execution,
delivery and  performance  of this  Agreement,  its Security  Agreement  and the
Notes.  No consent  or  authorization  of,  filing  with,  or other act by or in
respect  of any other  Person  (including  stockholders  and  creditors  of such
Borrower) or any  Governmental  Authority,  is required in  connection  with the
borrowings hereunder or with the execution, delivery,  performance,  validity or
enforceability of this Agreement,  its Security  Agreement or the Notes,  except
for the filing of financing statements required to perfect the security interest
intended to be granted by the Security Agreement.  This Agreement,  its Security
Agreement  and the Notes will be duly  executed  and  delivered on behalf of the
Borrower and this Agreement, its Security Agreement and the Notes, when executed
and delivered, will each constitute a legal, valid and binding obligation of the
Borrower  enforceable  against the Borrower in accordance with its terms, except
as  enforceability  may  be  limited  by  applicable   bankruptcy,   insolvency,
reorganization,   moratorium  or  similar  laws  affecting  the  enforcement  of
creditors' rights generally and equitable  principles of general  applicability,
regardless of whether  enforcement is sought in an action at law or a proceeding
in equity.

         3.4 Power,  Authorization,  Enforceable Obligations of Guarantors. Each
Guarantor has the power and  authority and the legal right to make,  deliver and
perform its Guarantee and Security  Agreement and the transactions  contemplated
thereby and has taken all necessary corporate action to authorize the execution,
delivery and performance of its Guarantee and Security Agreement.  No consent or
authorization of, filing with, or other act by or in respect of any other Person
(including  stockholders  and creditors of the  Guarantors) or any  Governmental
Authority is required in connection with the execution,  delivery,  performance,
validity or enforceability of such Guarantee or Security  Agreement,  except for
the filing of financing  statements  required to perfect the  security  interest
intended to be granted by the Security Agreement.  Each individual and corporate
Guarantee and each Security  Agreement  have been duly executed and delivered by
the  respective  parties  thereto,  and each such document  constitutes a legal,
valid and binding  obligation of the respective  Guarantor  enforceable  against
such Guarantor in accordance  with its terms,  except as  enforceability  may be
limited by  applicable  bankruptcy,  insolvency,  reorganization,  moratorium or
similar laws  affecting  the  enforcement  of  creditor's  rights  generally and
equitable principles of general applicability, regardless of whether enforcement
is sought in an action at law or a proceeding in equity.

                                       20


         3.5 No Legal Bar.  The  execution,  delivery  and  performance  of this
Agreement, the Security Agreement and the Notes and the borrowings hereunder and
the use of the proceeds thereof by the Borrower and the execution,  delivery and
performance  of  the  Guarantees  by  the  Guarantors,   will  not  violate  any
Requirement  of  Law or  any  Contractual  Obligation  of  the  Borrower  or the
Guarantors,  and will not result in, or require,  the creation or  imposition of
any Lien on any of its properties or revenues pursuant to any Requirement of Law
or Contractual Obligation except those in favor of the Bank provided herein.

         3.6 No Material Litigation. No litigation,  investigation or proceeding
of or before any arbitrator or  Governmental  Authority is pending by or against
any  Specified  Person or against any of their  properties  or revenues (a) with
respect to this Agreement,  the Security Agreement,  Notes, or the Guarantees or
any of the  transactions  contemplated  hereby or thereby,  or (b) except as set
forth in the Company's  Quarterly Report on Form 10-Q for the quarter ended June
30, 1998, which if adversely determined, would have a material adverse effect on
the  business,  operations,  property or  financial  or other  condition  of the
Borrower and its Subsidiaries or of the Guarantors.

         3.7 No Default. No Specified Person is in default under or with respect
to any Contractual  Obligation in any respect which could be materially  adverse
to the  business,  operations,  property or financial or other  condition of the
Borrower  or any of  its  Subsidiaries  or of the  Guarantors,  or  which  could
materially  and adversely  affect the ability of (i) the Borrower to perform its
obligations under this Agreement,  its Security Agreement, the Notes or any Loan
Document  to which  it is a  party,  or (ii) the  Guarantors  to  perform  their
obligations  under the  Guarantees.  No Default or Event of Default has occurred
and is continuing.

         3.8  No  Burdensome  Restrictions.  No  Contractual  Obligation  of any
Specified  Person and no  Requirement of Law materially  adversely  affects,  or
insofar as the  Borrower may  reasonably  foresee may so affect,  the  business,
operations,  property or  financial  or other  condition  of any such  Specified
Person.

         3.9 Taxes.  The Borrower and the Guarantors  have filed or caused to be
filed all tax returns  which to the knowledge of the Borrower are required to be
filed, and have paid all taxes shown to be due and payable on said returns or on
any assessments made against them or any of their property.

         3.10  Federal  Regulations.  The  Borrower  is not  engaged nor will it
engage,  principally or as one of its important  activities,  in the business of
extending  credit for the  purpose of  "purchasing"  or  "carrying"  any "margin
stock"  within  the  respective  meanings  of each  of the  quoted  terms  under
Regulation U of the Board of Governors of the Federal  Reserve System as now and
from time to time  hereafter  in effect.  No part of the  proceeds  of any Loans
hereunder  will be used for  "purchasing"  or  "carrying"  "margin  stock" as so
defined or for any purpose which violates,  or which would be inconsistent with,
the provisions of the Regulations of such Board of Governors.

                                       21


         3.11 Environmental Matters.

         (a) None of the Real Property contains, or to the best knowledge of the
Borrower  has  previously  contained,  (i)  any  hazardous  or  toxic  waste  or
substances in amounts or  concentrations  which (A)  constitute or constituted a
violation of or (B) could reasonably be expected to give rise to liability under
any  applicable  environmental  law,  except  in  either  case  insofar  as such
violation  or  liability  could not  reasonably  be  expected to have a material
adverse  effect  on the  business,  operations  or  financial  condition  of the
Borrower and the Guarantors or (ii) any underground  storage tanks,  except such
as  have  been  removed  or  remediated  in  accordance   with  all   applicable
environmental laws.

         (b) The Real Property is in  compliance  in all material  respects with
all applicable federal, state and local environmental standards and requirements
affecting such Real Property, and there are no environmental conditions of which
Borrower has knowledge which could  interfere in any material  respects with the
continued use of the Real Property.

         (c) Neither the Borrower nor any of its  Subsidiaries nor any Guarantor
has received any notices of violations or advisory action by regulatory agencies
regarding environmental control matters or environmental permit compliance.

         (d)  Hazardous  waste  has not  been  transferred  from any of the Real
Property to any other  locations  except in compliance in all material  respects
with all applicable environmental laws, regulations or permit requirements.

         (e)  With  respect  to the Real  Property,  there  are no  proceedings,
governmental  administrative  actions or judicial proceedings pending or, to the
best knowledge of the Borrower,  contemplated under any federal,  state or local
law regulating the discharge of hazardous or toxic  materials or substances into
the environment,  to which the Borrower or any of its Subsidiaries is named as a
party.

         3.12. Year 2000 Issue. The Borrower and its Subsidiaries  have reviewed
the  effect  of the Year  2000  Issue on the  computer  software,  hardware  and
firmware systems and equipment  containing embedded microchips owned or operated
by or for the  Borrower  and its  Subsidiaries  or  used or  relied  upon in the
conduct of their business (including systems and equipment supplied by others or
with  which  such  computer   systems  of  the  Borrower  and  its  Subsidiaries
interface).  The costs to the Borrower and its Subsidiaries of any reprogramming
required as a result of the Year 2000 Issue to permit the proper  functioning of
such systems and equipment and the proper processing of data, and the testing of
such reprogramming,  and of the reasonably foreseeable  consequences of the Year
2000 Issue to the Borrower or any of its Subsidiaries  (including  reprogramming
errors  and the  failure of systems or  equipment  supplied  by others)  are not
reasonably  expected  to result in a Default  or Event of  Default  or to have a
material  adverse  effect on the  business,  assets,  operations,  prospects  or
condition (financial or otherwise) of the Borrower or any of its Subsidiaries.


                                       22


4.       CONDITIONS PRECEDENT.

         4.1 Conditions to Initial  Extensions of Credit.  The obligation of the
Bank to make the  initial  extension  of credit  to the  Borrower  hereunder  is
subject to the satisfaction of the following conditions precedent:

                  (a) Notes and  Agreements.  The Bank shall have  received  the
Facility A Revolving  Credit Note, the Facility B Revolving  Credit Note and the
Term  Note,  conforming  to the  requirements  hereof and duly  executed  by the
Borrower.

                  (b)  Guarantees.  The Bank shall have received the  Guarantees
substantially in the form of Exhibit F hereto duly executed by each Guarantor.

                  (c) Security  Agreements.  The Bank shall have  received (i) a
Security  Agreement  from the Borrower and each Guarantor  substantially  in the
form of Exhibit G hereto,  together with UCC-1 financing  statements executed by
each such entity in favor of the Bank.

                  (d) Borrower Pledge Agreement.  The Bank shall have received a
Borrower Pledge Agreement from the Borrower substantially in the form of Exhibit
H hereto duly executed by the Borrower.

                  (e) Borrowing Base  Certificate.  The Bank shall have received
and satisfactorily reviewed a Borrowing Base Certificate as set forth in Section
5.2(c) hereof.

                  (f) Legal Opinion.  The Bank shall have received an opinion of
counsel to the Borrower and each Guarantor  substantially in the form of Exhibit
E hereto.  Such  opinion  shall also cover such other  matters  incident  to the
transactions  contemplated  by this Agreement and the Loan Documents as the Bank
shall reasonably require.

                  (g)  Origination  Fees.  The Bank  shall  have  been  paid the
aggregate  $50,000 balance of the  origination  fees described in the Commitment
Letter.

                  (h) Certificates and Resolutions. The Bank shall have received
(i)  copies  of the  resolutions  of the  board  of  directors  of the  Borrower
authorizing  the execution,  delivery and  performance of this Agreement and the
Loan  Documents  certified by the  Secretary  or an Assistant  Secretary of such
corporation  and like  resolutions of each Guarantor  authorizing the execution,
delivery and performance of its respective Guarantee and Security Agreement,  if
any, certified  respectively by the Secretary or an Assistant  Secretary of each
such corporation;  (ii) a certificate of the Secretary or an Assistant Secretary
of the Borrower and each Guarantor  certifying the names and true  signatures of
the officers of each such  corporation  authorized to sign any and all documents
to be  delivered  by  each  such  corporation  or as  required  or  contemplated
hereunder;  and  (iii)  good  standing  certificates  issued  by the  applicable
Governmental Authority.

                  (i) Lien Searches. The Bank shall have received the results of
searches of Uniform  Commercial  Code and other Lien filings with respect to the
Borrower  in each state  where it  conducts  business  and such  searches  shall
disclose no Liens on any assets  encumbered,  except for Liens  permitted  under
Section 7.4, or if unpermitted Liens are disclosed, the Bank shall have received
satisfactory evidence of release of such Liens.

                                       23


                  (j) Commitment  Letter.  The Borrower shall have satisfied all
the terms and conditions of the Commitment Letter.

                  (k) Legal  Structure.  The Bank  shall be  satisfied  with the
corporate and legal  structure  and  capitalization  of the Company,  including,
without limitation,  the charter and bylaws of the Company and each agreement or
instrument relating thereto.

                  (l) Examination.  The Bank shall have conducted an examination
of the  Company's  books and  records  and the books and  records of the Network
Sites  (subject  to  applicable  laws  and   regulations   relating  to  patient
confidentiality),  at the Company's expense, by an examiner  satisfactory to the
Bank and such  examination  shall be in form and substance  satisfactory  to the
Bank.

                  (m) Consents.  All governmental  and third-party  consents and
approvals   necessary  in  connection  with  each  aspect  of  the  transactions
contemplated by this Agreement shall have been obtained  (without the imposition
of any  conditions  that are not  acceptable  to the Bank)  and shall  remain in
effect;  all applicable waiting periods shall have expired or been terminated or
waived  without  any  adverse  action  being  taken  by  any  authority   having
jurisdiction;  and no law or  regulation  shall be applicable in the judgment of
the Bank that restrains,  prevents or imposes material  adverse  conditions upon
any aspect of the transactions contemplated by this Agreement.

                  (n) Compliance.  The intended use of the proceeds of the Loans
shall  be in full  compliance  with  all  applicable  laws,  including,  without
limitation,  Regulations  G, T, U and X of the Board of Governors of the Federal
Reserve System.

                  (o) Additional Matters.  All other documents and legal matters
in connection  with the  transactions  contemplated  by this Agreement  shall be
satisfactory in form and substance to the Bank and its counsel.

         4.2 Conditions to All Extensions of Credit.  The obligation of the Bank
to make any Loan  (including  the initial  Loans) to be made by it  hereunder is
subject to the satisfaction of the following conditions precedent:

                  (a)  Representations  and Warranties.  The representations and
warranties   made  by  the  Borrower  herein  or  which  are  contained  in  any
certificate,  document or financial or other written statement  furnished at any
time  under  or in  connection  herewith,  shall  be  correct  on  and as of the
borrowing  date for such  extension  of credit as if made on and as of such date
except to the extent any such  representation or warranty expressly speaks as of
a specific date.

                  (b) No  Default  or Event of  Default.  No Default or Event of
Default shall have occurred and be continuing on the date an extension of credit
is to be made or after  giving  effect to the  extension of credit to be made on
such date.

                                       24


                  (c) Compliance with Borrowing Base. As to Facility A Revolving
Credit Loans only,  after  taking into  account the Facility A Revolving  Credit
Loan to be made, all outstanding Facility A Revolving Credit Loans together with
the  requested  Facility A Revolving  Credit Loan shall not exceed the Borrowing
Base.

                  (d)  Compliance  with  Section 7.2. As to Facility B Revolving
Credit Loans only,  the Borrower  shall be in full  compliance  with each of the
provisions set forth in Section 7.2.

         Each   borrowing  by  the  Borrower   hereunder   shall   constitute  a
representation  and  warranty  by the  Borrower  as of the  date  of  each  such
borrowing  that the  conditions in clauses (a), (b), (c) and (d) of this Section
have been satisfied.


5.       AFFIRMATIVE COVENANTS.

         The Borrower  hereby agrees that, so long as any Commitment  remains in
effect, any Note remains outstanding and unpaid, or any other amount is owing to
the Bank  hereunder,  the Borrower will and will cause each Specified  Person as
applicable to:

         5.1 Corporate Existence and Qualification.  Take the necessary steps to
preserve its corporate existence and its right to conduct business in all states
in which the  nature of its  business  requires  qualification  to do  business,
except where the failure so to qualify could not  reasonably by expected to have
a material adverse effect on the business,  operations or financial condition of
the Borrower or the Guarantors.

         5.2 Financial Information and Compliance Certificates.

                  (a)  Keep  its  books  of  account  in  accordance  with  good
accounting  practices  and furnish to the Bank within 90 days after the last day
of each of its fiscal years, (i) the consolidated balance sheets of the Borrower
and its  Subsidiaries  as at such last day of the fiscal year and  statements of
income and retained  earnings and cash flows for such fiscal year each  prepared
in accordance with GAAP consistently applied and certified without qualification
by a firm of independent certified public accountants reasonably satisfactory to
the  Bank;  and  within  (ii) 45 days  after  the  close  of each  fiscal  month
consolidated balance sheets, statements of income and retained earnings and cash
flows of the  Borrower and its  Subsidiaries  as of the last day of and for such
month  and for the  period  of the  fiscal  year  ended  as of the  close of the
particular month, all such monthly  statements to be in reasonable  detail,  and
certified by the chief financial or accounting officer of the Borrower as having
been  prepared in  accordance  with GAAP  (exclusive of footnotes and subject to
year-end  adjustments).  The Borrower  will also,  with  reasonable  promptness,
furnish such other data as may be  reasonably  requested by the Bank and will at
all  times  and  from  time to time  permit  the Bank by or  through  any of its
officers,  agents,  employees,  attorneys  or  accountants  to inspect  and make
extracts from such Borrower's books and records.

                                       25


                  (b)  Within 45 days  after the close of each  fiscal  quarter,
deliver a certificate  of the  president  and the chief  financial or accounting
officer  of the  Borrower  evidencing  a  computation  of  compliance  with  the
provisions  of Section 6 hereof and a  computation  of the Leverage  Ratio (each
including supporting detail of each applicable  calculation) and stating that in
each case  except as  disclosed  in such  certificate,  the person  making  such
certificate has no knowledge of any Default or Event of Default.

                  (c) Within 30 days after the last day of each  month,  deliver
to the Bank an accounts receivable agings report accompanied by a Borrowing Base
Certificate  indicating a computation  of the Borrowing Base and executed by the
chief  financial  or  accounting  officer of the  Borrower,  covering the period
ending the last day of the immediately preceding month.

                  (d) Promptly after the same are sent,  copies of all financial
statements  and  reports  which  the  Borrower  sends to its  stockholders,  and
promptly  after the same are  filed,  copies  of all  financial  statements  and
reports  which  the  Borrower  may  make  to,  or file  with,  any  Governmental
Authority, agency, commission, board or bureau.

                  (e) Within five days of any officer of the Borrower  obtaining
knowledge of any Default,  if such Default is then  continuing,  Borrower  shall
furnish to the Bank a certificate of the chief  financial or accounting  officer
of the  Borrower  setting  forth the details  thereof  and the action  which the
Borrower is taking or proposes to take with respect thereto.

         5.3  Insurance.  Maintain  insurance  with  responsible  and  reputable
insurance  companies or  associations in such amounts and covering such risks as
are  usually  carried by  companies  engaged in  similar  businesses  and owning
similar  properties in the same general areas in which the Borrower operates and
naming the Bank as an additional insured or loss payee (as appropriate)  thereon
as its interest may appear.

         5.4  Preservation  of  Properties;  Compliance  with Law.  Maintain and
preserve all of its properties which are used or which are useful in the conduct
of its  business in good working  order and  condition,  ordinary  wear and tear
excepted and comply in all material respects with all Requirements of Law .

5.5 Taxes. Duly pay and discharge all taxes or other claims which might become a
lien upon any of its property except to the extent that any thereof are being in
good faith appropriately contested with adequate reserves provided therefor.

         5.6 Maintain Operating Accounts.  Maintain all of its primary operating
accounts  with the Bank,  unless  the  Borrower  shall  have  provided  evidence
reasonably  satisfactory to the Bank that for geographical  purposes or in order
to comply with  applicable  Requirements of Law such accounts are required to be
maintained elsewhere.

                                       26


         5.7 Notice of  Litigation.  Promptly  notify the Bank in writing of any
litigation,  legal  proceeding  or dispute,  other than disputes in the ordinary
course of  business  or,  whether  or not in the  ordinary  course of  business,
involving amounts in excess of $50,000, affecting the Borrower or any Subsidiary
whether or not fully covered by insurance,  and regardless of the subject matter
thereof  (excluding,  however,  any actions  relating  to workers'  compensation
claims or negligence claims relating to use of motor vehicles,  if fully covered
by insurance, subject to deductibles).

         5.8 Indemnity (Environmental  Matters).  Indemnify the Bank against any
liability,  loss,  cost,  damage,  or expense  (including,  without  limitation,
reasonable  attorneys'  fees) arising from (i) the  imposition or recording of a
lien by any  local,  state,  or federal  government  or  governmental  agency or
authority  pursuant to any  Cleanup  Laws;  (ii)  claims of any private  parties
regarding  violations of Cleanup Laws; and (iii) costs and expenses  (including,
without  limitation,  reasonable  attorneys'  fees  and fees  incidental  to the
securing of  repayment  of such costs and  expenses)  incurred by any  Specified
Person or the Bank in connection with compliance by any Specified  Person or the
Bank with any statute,  regulation or order issued  pursuant to any Cleanup Laws
by any local, state or federal government or governmental agency or authority.

         5.9 Year 2000 Issue.  Take, and shall cause each of its Subsidiaries to
take,  all  necessary  action to complete in all material  respects by March 31,
1999, the reprogramming of computer software,  hardware and firmware systems and
equipment  containing  embedded  microchips  owned  or  operated  by or for  the
Borrower  and its  Subsidiaries  or used or relied  upon in the conduct of their
business  (including systems and equipment supplied by others or with which such
systems of the  Borrower  or any of its  Subsidiaries  interface)  required as a
result of the Year 2000 Issue to permit the proper  functioning of such computer
systems and other equipment and the testing of such systems and equipment, as so
reprogrammed.  At the request of the Bank, the Borrower shall provide, and shall
cause each of its Subsidiaries to provide,  to the Bank reasonable  assurance of
its compliance with the preceding sentence.

         5.10 Material  Subsidiaries.  Cause each direct and indirect Subsidiary
of the  Borrower to become a Guarantor  (unless  the Bank has  provided  written
notice to the Borrower  that such  Subsidiary  is not, in the Bank's  reasonable
judgment, a "material"  Subsidiary of the Borrower) and take any action as shall
be  necessary to grant the Bank a first  priority  perfected  security  interest
(subject to liens  permitted by Section  7.4) in all the issued and  outstanding
Capital  Stock  and  all  the  personal  property  and  fixtures  of  each  such
Subsidiary.

         5.11 Reserved.

         5.12 After-Acquired Stock. Deliver to the Bank any After-Acquired Stock
(as defined in Section 7.3  hereof) and a stock power in  connection  therewith,
substantially  in the form of Exhibit I hereto,  executed by the Borrower,  such
delivery  to occur not more than 10 days  after the  acquisition  of such  After
Acquired Stock.

                                       27


6.       FINANCIAL COVENANTS.

         The Borrower  hereby agrees that, so long as any Commitment  remains in
effect, any Note remains outstanding and unpaid, or any other amount is owing to
the Bank hereunder,  the Borrower and its  Subsidiaries on a consolidated  basis
will:

         6.1 Fixed Charge  Coverage  Ratio.  Maintain as at the last day of each
fiscal quarter a Fixed Charge Coverage Ratio of not less than 1.2 to 1.0.

         6.2  Consolidated  Effective Net Worth.  Maintain as at the last day of
each fiscal quarter Consolidated  Effective Net Worth in an amount not less than
$26,750,000,  plus 50% of the  Consolidated  Adjusted Net Income of the Borrower
and its Subsidiaries,  on a cumulative basis, commencing with June 30, 1998, for
the fiscal quarter then ending (provided,  that,  notwithstanding the definition
of Adjusted Net Income, there shall not be any reduction for any net loss), plus
80% of the net  proceeds,  on a  cumulative  basis,  received by the Borrower in
connection  with any issuance of  securities  (whether for cash or otherwise) by
the Borrower during the fiscal quarter then ending.

         6.3 Adjusted Leverage Ratio. Maintain as at the last day of each fiscal
quarter a ratio of  Consolidated  Senior  Funded Debt to  Consolidated  Adjusted
EBITDA of not more than 2.5 to 1.0.

7.       NEGATIVE COVENANTS.

         The Borrower  hereby agrees that, so long as any Commitment  remains in
effect, any Note remains outstanding and unpaid, or any other amount is owing to
the Bank  hereunder it will not, nor will it permit any of its  Subsidiaries  or
any Guarantor or any of its Subsidiaries to:

         7.1  Indebtedness  for Borrowed Money.  Incur, or permit to exist,  any
Indebtedness  for borrowed money except (i)  Indebtedness  incurred  pursuant to
borrowings  hereunder  and  under  any  other  loans  made  by the  Bank  in its
discretion to the Borrower or any Subsidiary,  (ii) Indebtedness existing on the
date hereof and reflected in the financial statements referred to in Section 3.1
hereof,  (iii)  Indebtedness  incurred  after the date of this  Agreement  in an
aggregate  amount not in excess of $1,125,000 in any fiscal year (except for the
period from the date hereof  through  December  31, 1998 such  aggregate  amount
shall be $750,000)  and not in excess of $3,000,000 in the aggregate at any time
outstanding; provided, that, same is incurred in connection with the acquisition
of fixed assets  within the  limitations  of Section 7.8 hereof,  (iv)  purchase
money  Indebtedness  incurred in connection with Permitted  Acquisitions and (v)
Indebtedness  of a Person which is the subject of a Permitted  Acquisition or to
which any assets or business  acquired in a  Permitted  Acquisition  are subject
provided that, in each case, such  Indebtedness  existed at the time of, and was
not created in anticipation of, such Permitted Acquisition.

7.2      Mergers, Acquisitions and Sales of Assets.
        
         (a) Enter  into any merger or  consolidation  or  liquidate,  windup or
dissolve  itself or sell,  transfer or lease or otherwise  dispose of all or any
substantial  part of its assets  (other than (i) sales of inventory and obsolete
equipment  in the  ordinary  course  of  business  and (ii) the  disposition  of
Reproductive Science Associates,  Inc. and Reproductive Science Center of Dallas
by means of the sale of the Management Contract relating to such practice to the
physician/owner  of such practice  except that any  Subsidiary may merge into or
consolidate  with any other Subsidiary which is wholly-owned by the Borrower and
any  Subsidiary  which  is  wholly-owned  by the  Borrower  may  merge  with  or
consolidate  into the  Borrower  provided  that the  Borrower  is the  surviving
corporation.

                                       28


         (b) Make any  Acquisition  other than as  provided  in  Section  7.2(a)
unless  each  of  the  following  conditions  shall  have  been  satisfied  (any
Acquisition  permitted  by  Section  7.2(a)  or  whereby  each of the  following
conditions shall have been satisfied shall be referred to herein as a "Permitted
Acquisition"):

                  (i) the  Acquisition  Cost in respect thereof shall not exceed
(i) $8,000,000 with respect to any individual Acquisition;  and (ii) $20,000,000
in the aggregate during any fiscal year;

                  (ii) no Default or Event of Default  shall  exist  immediately
before or after giving effect thereto;

                  (iii) the Person,  business or assets  acquired in  connection
with such  Acquisition are related to the infertility and assisted  reproductive
technology services business;

                  (iv) the Borrower  shall have  delivered to the Bank, not less
than 10 days prior to the consummation of such Acquisition, (i) a certificate of
a financial officer of the Borrower, in all respects reasonably  satisfactory to
the  Bank  and  dated  the  date of such  consummation,  attaching  a  pro-forma
compliance  certificate  (in a format  satisfactory  to the Bank)  after  giving
effect to such  Acquisition  and based on the most recent  financial  statements
delivered to the Bank pursuant to this Agreement and (ii) copies of the purchase
or merger agreement or any other material  documents executed in connection with
the Acquisition;

                  (v) immediately  after giving effect to each such Acquisition,
all of the representations  and warranties  contained in Section 3 shall be true
and  correct as if then made  except to the extent  any such  representation  or
warranty expressly speaks of a specific date;

                  (vi) the  Acquisition  shall have the  approval  of the target
company's board of directors (or similar governing body);

                  (vii) the Bank shall have received such other  information  or
documents  as it  shall  have  reasonably  requested  in  connection  with  such
Acquisition.

                  (viii)  the  acquisition   shall  have  been   consummated  in
accordance  with the  definitive  acquisition  agreement,  without any waiver or
amendment of any term or condition  therein not  consented to by the Bank and in
compliance with all applicable laws and all necessary approvals;

                                       29


                  (ix) the Bank shall be satisfied that any otherwise applicable
state takeover law and any applicable  supermajority  charter provisions are not
applicable  to  the   Acquisition  or  that  any  conditions  to  avoiding  such
restrictions have been satisfied;

                  (x) all  governmental  and third-party  consents and approvals
necessary  in  connection  with each aspect of the  Acquisition  shall have been
obtained  (without the imposition of any  conditions  that are not acceptable to
the Bank) and shall remain in effect;  all applicable waiting periods shall have
expired or been  terminated or waived  without any adverse action being taken by
any authority having jurisdiction;  and no law or regulation shall be applicable
in the judgment of the Bank that restrains, prevents or imposes material adverse
conditions upon any aspect of the Acquisition; and

                  (xi) any Acquisition  with a total  Acquisition Cost in excess
of $1,000,000 or any Acquisition  occurring after the Borrower has paid,  during
any twelve-month period, in excess of $3,000,000 in Acquisition Costs in respect
of all such  Acquisitions  during such  period,  will require the consent of the
Bank.

         7.3 Lending, Advances and Investments. Lend or advance money, credit or
property to or invest in (by capital contribution,  loan, purchase or otherwise)
any  firm,  corporation,   or  other  Person  except  (i)  investments  in  Cash
Equivalents,  (ii) accounts  receivable arising out of sales of inventory or the
rendering of services in the ordinary course of business (iii) loans or advances
not in excess of  $1,500,000  in the  aggregate at any one time  outstanding  to
Practice Groups who have executed a Management Agreement with the Borrower, (iv)
purchases of accounts receivable pursuant to Management  Agreements to which the
Borrower or any  Subsidiary  is party;  provided same is existing as of the date
hereof or  arises  out of a  Permitted  Acquisition,  (v) a loan in a  principal
amount of up to $50,000 to Gerardo Canet and a loan in a principal  amount of up
to $15,000 to Donald Wood to enable each to exercise  options to purchase  stock
of the Borrower, (vi) loans to officers, directors and employees in an aggregate
amount at any one time outstanding not to exceed $500,000, (vii) the purchase of
537 shares of Shady Grove  Fertility  Centers,  Inc. not presently  owned by the
Borrower,  from Robert J.  Stillman,  M.D.  ("After-Acquired  Stock") and (viii)
payroll advances to employees which are to be repaid through payroll deduction.

         7.4 Liens.  Create,  assume or permit to exist,  any Lien on any of its
property or assets now owned or hereafter  acquired except (i) Liens in favor of
the Bank;  (ii) other Liens  incidental  to the  conduct of its  business or the
ownership of its property and assets which were not incurred in connection  with
the  borrowing of money or the  obtaining of advances or credit and which do not
materially impair the use thereof in the operation of its business;  (iii) Liens
for taxes or other  governmental  charges which are not  delinquent or which are
being  contested  in  good  faith  and for  which  a  reserve  shall  have  been
established in accordance with generally accepted  accounting  principles;  (iv)
purchase  money Liens granted to secure the unpaid  purchase  price of any fixed
assets  purchased  within the  limitations  of Section 7.8 hereof;  (v) judgment
Liens in existence  less than 30 days after the entry thereof or with respect to
which execution has been stayed;  (vi) any interest or title of a lessor secured
by a lessor's  interest under any lease permitted by this  Agreement;  and (vii)
leases or subleases  granted to others not  interfering in any material  respect
with the business of such Person..

                                       30


         7.5 Contingent Liabilities. Assume, endorse, be or become liable for or
guarantee the obligations of any Person excluding  however,  (i) the endorsement
of negotiable  instruments  for deposit or collection in the ordinary  course of
business;  (ii) the  Guarantees and (iii) the assumption of leases in connection
with an Acquisition.

         7.6  Dividends.  (a) Declare or pay any dividends on its Capital Stock,
except (i) dividends  payable solely in shares of its own common stock,  (ii) as
long as no Default or Event of Default has occurred and is continuing, dividends
in connection  with the Borrower's  outstanding  preferred stock in an aggregate
amount not in excess of  $133,000  in any fiscal  year and (iii) any  Subsidiary
wholly owned by the Borrower may declare and pay dividends to the  Borrower,  or
(b) purchase,  redeem,  retire or otherwise  acquire any of its Capital Stock at
any time  outstanding  (other than in connection with the surrender of shares of
the  Borrower's  Series  A  Cumulative  Convertible  Preferred  Stock  upon  its
conversion into shares of the Borrower's Common Stock).

         7.7  Sales  of  Receivables;  Sale  -  Leasebacks.  Sell,  discount  or
otherwise  dispose of notes,  accounts  receivable or other obligations owing to
the Borrower, with or without recourse,  except for the purpose of collection in
the ordinary course of business; or sell any asset pursuant to an arrangement to
thereafter lease such asset from the purchaser thereof.

         7.8 Capital Expenditures; Capitalized Leases. Expend or agree to expend
in the aggregate for the Borrower and all  Subsidiaries  in excess of $1,500,000
in any fiscal year for Capital  Expenditures  including  assets  acquired  under
Capitalized  Leases,   excluding  amounts  paid  in  connection  with  Permitted
Acquisitions.

         7.9 Lease  Payments.  Expend in the  aggregate for the Borrower and all
Subsidiaries in excess of $2,000,000 in any fiscal year for the lease, rental or
hire of real or personal  property  pursuant to any rental  agreement  therefor,
whether an operating lease, capitalized lease or otherwise.

         7.10 Nature of Business.  Materially  alter the nature of its business.

         7.11 Stock of Subsidiaries. Sell or otherwise dispose of any Subsidiary
(except in connection  with a merger or  consolidation  of a Subsidiary into the
Borrower or another  Subsidiary)  or permit a Subsidiary to issue any additional
shares of its capital stock except pro rata to its stockholders.

         7.12  ERISA.  (i)  Terminate  any Plan so as to result in any  material
liability to the Pension Benefit Guaranty  Corporation  established  pursuant to
Subtitle  A of Title IV of ERISA  (the  "PBGC"),  (ii)  engage in or permit  any
person under its control to engage in any "prohibited  transaction"  (as defined
in Section 406 of ERISA or Section 4975 of the Internal Revenue Code of 1954, as
amended)  involving any Plan which would subject a Borrower to any material tax,
penalty  or other  liability,  (iii)  incur or  suffer  to  exist  any  material
"accumulated  funding deficiency" (as defined in Section 302 of ERISA),  whether
or not waived, involving any Plan, or (iv) allow or suffer to exist any event or
condition,  which presents a material risk of incurring a material  liability to
the PBGC by reason of termination of any Plan.

                                       31


         7.13  Accounting  Changes.  Make, or permit any  Subsidiary to make any
change in its accounting  treatment or financial  reporting  practices except as
required or permitted by GAAP in effect from time to time.

         7.14 Transactions with Affiliates. Except for the Management Agreements
and  as  otherwise  specifically  set  forth  in  this  Agreement,  directly  or
indirectly  purchase,  acquire or lease any property from, or sell,  transfer or
lease any property to, or enter into any other  transaction,  with any Affiliate
except in the  ordinary  course of business  and at prices and on terms not less
favorable  to it than those  which would have been  obtained in an  arm's-length
transaction with a non-affiliated third party.


8.       EVENTS OF DEFAULT.

         Upon the occurrence and during the  continuance of any of the following
events (each an Event of Default):

         (a) Borrower  shall fail to pay principal of any of the Notes when due,
or shall fail to pay any interest,  or other amount payable hereunder within two
Business Days after the same becomes due; or

         (b) Any  representation or warranty made or deemed made by the Borrower
herein or which is contained in any certificate,  document or financial or other
written  statement  furnished  at any time  under  or in  connection  with  this
Agreement shall prove to have been false in any material respect on or as of the
date made or deemed made; or

         (c) Borrower  shall  default in the  observance or  performance  of any
covenant or provision contained in Section 6 or 7 hereof; or

         (d) Borrower  shall  default in the  observance or  performance  of any
other provision  contained in this Agreement or any other Loan Document and such
default  shall  continue  unremedied  with respect to other  provisions  of this
Agreement for a period of 10 days after written  notice  thereof is given to the
Borrower  by the  Bank and  with  respect  to other  Loan  Documents  after  the
expiration of any applicable grace or cure periods; or

         (e) Any Specified  Person shall (i) default in any payment in excess of
$10,000 in the aggregate  with respect to any  Indebtedness  for borrowed  money
(other than the Notes) in excess of $50,000 beyond the period of grace,  if any,
provided  in the  instrument  or  agreement  under which such  Indebtedness  was
created; or (ii) default in the observance or performance of any other agreement
or condition relating to any such indebtedness or contained in any instrument or
agreement  evidencing,  securing  or  relating  thereto or any other event shall
occur or  condition  exist,  in each case the  effect of which  default or other
event  or  condition  is to  cause or  permit  the  holder  or  holders  of such
Indebtedness  (or a trustee  or agent on behalf of such  holder or  holders)  to
cause such Indebtedness to become due prior to its stated maturity; or

                                       32


         (f) (i) Any  Specified  Person shall  commence any case,  proceeding or
other action (A) under any existing or future law of any jurisdiction,  domestic
or foreign,  relating to  bankruptcy,  insolvency,  reorganization  or relief of
debtors,  seeking to have an order for  relief  entered  with  respect to it, or
seeking to  adjudicate it a bankrupt or  insolvent,  or seeking  reorganization,
arrangement,  adjustment, winding-up, liquidation,  dissolution,  composition or
other relief with respect to it or its debts,  or (B) seeking  appointment  of a
receiver,  trustee, custodian or other similar official for it or for all or any
substantial  part of its assets,  or any  Specified  Person shall make a general
assignment  for the benefit of its  creditors;  or (ii) there shall be commenced
against any  Specified  Person any case,  proceeding or other action of a nature
referred  to in clause (i) above  which (A) results in the entry of an order for
relief or any such  adjudication  or  appointment  or (B)  remains  undismissed,
undischarged  or  unbonded  for a period  of 60 days;  or (iii)  there  shall be
commenced  against any  Specified  Person any case,  proceeding  or other action
seeking  issuance of a warrant of  attachment,  execution,  distraint or similar
process against all or any  substantial  part of its assets which results in the
entry of an  order  for any  such  relief  which  shall  have not been  vacated,
discharged,  or stayed or bonded  pending  appeal  within 30 days from the entry
thereof;  or (iv) any Specified  Person shall take any action in furtherance of,
or indicating its consent to, approval of, or  acquiescence  in, any of the acts
set  forth  in  clause  (i),  (ii) or  (iii) of this  Section  8(f);  or (v) any
Specified  Person shall  generally not, or shall be unable to, or shall admit in
writing its inability to, pay its debts as they become due; or

         (g)  (i)  any  Specified   Person  shall  engage  in  any   "prohibited
transaction"  (as defined in Section  406 of ERISA or Section  4975 of the Code)
involving any Plan,  (ii) any  "accumulated  funding  deficiency" (as defined in
Section 302 of ERISA),  whether or not waived,  shall exist with  respect to any
Plan, (iii) a Reportable Event shall occur with respect to, or proceedings shall
commence  to have a trustee  appointed,  or a  trustee  shall be  appointed,  to
administer or to terminate,  any Plan,  which Reportable Event or institution of
proceedings is, in the reasonable  opinion of the Bank,  likely to result in the
termination of such Plan for purposes of Title IV of ERISA,  and, in the case of
a Reportable  Event, the continuance of such Reportable Event unremedied for ten
days after notice of such Reportable Event pursuant to Section  4043(a),  (c) or
(d) of ERISA is given or the continuance of such  proceedings for ten days after
commencement  thereof,  as the case may be,  (iv) any Plan shall  terminate  for
purposes  of Title IV of ERISA,  and in each case in clauses  (i)  through  (iv)
above, such event or condition could subject the Borrower to any tax, penalty or
other  liabilities  in the  aggregate  material  in  relation  to the  business,
operations or property of the Borrower; or

         (h)  the  rendition  by any  court  of a  final  judgment  against  any
Specified Person in excess of $50,000 (to the extent not covered by insurance as
to  which  the  insurer  has   acknowledged   liability)   which  shall  not  be
satisfactorily  stayed,  discharged,  vacated or set aside within 60 days of the
making thereof;  or the attachment of any property of any Specified Person which
has not been released or provided for to the reasonable satisfaction of the Bank
within 60 days after the making thereof; or

         (i) any Guarantee of any Guarantor  shall cease to be in full force and
effect  (other than by reason of a  transaction  permitted by Section  7.2(a) of
this Agreement); or

                                       33


         (j) any of the Liens  created  and  granted  pursuant  to the  Security
Agreement(s) shall fail to be valid, first,  perfected Liens subject to no prior
or equal Lien except as permitted by this Agreement; or

         (k) a Change of Control shall occur; or

         (l) the Bank shall have  determined in its reasonable  discretion  that
there has occurred a material  adverse  change in the  business,  properties  or
financial condition of the Borrower;

then, in any such event,  any or all of the following  actions may be taken: (i)
the Bank may, at its option,  declare either or all Commitments to be terminated
forthwith,  whereupon such Commitment(s) and all obligations of the Bank to make
Revolving Credit Loans shall  immediately  terminate;  (ii) the Bank may, at its
option,  declare the Loans  hereunder  (with accrued  interest  thereon) and all
other amounts owing under this Agreement and the Notes to be due and payable and
the same,  and all interest  accrued  thereon,  shall  forthwith  become due and
payable without presentment, demand, protest or notice of any kind, all of which
are hereby waived, anything contained herein or in any instrument evidencing the
Loans to the contrary notwithstanding.


9.       COLLATERAL SECURITY.

         9.1 General Loan and Collateral  Agreement.  As collateral security for
the payment of the Obligations,  the Borrower and each Guarantor hereby grant to
the Bank a lien on and security  interest in and right of setoff with respect to
any and all deposits or other sums at any time  credited by or due from the Bank
or any Affiliate of the Bank to the Borrower  and/or any Guarantor,  whether now
existing or hereafter arising, whether in regular or special depository accounts
or otherwise, and any and all monies, credit,  collateral,  securities and other
property of the Borrower and/or any Guarantor, whether now existing or hereafter
arising,  and the proceeds  thereof,  now or hereafter held or received by or in
transit to the Bank or any Affiliate of the Bank from or for the Borrower and/or
any  Guarantor,   whether  for  safekeeping,   custody,  pledge,   transmission,
collection or otherwise. At any time, without demand or notice, the Bank may set
off the same or any part thereof and apply the same to any of the Obligations of
the Borrower  and/or any Guarantor  even though  unmatured and regardless of the
adequacy  of any other  collateral  securing  the  Loans.  ANY AND ALL RIGHTS TO
REQUIRE THE BANK TO EXERCISE  ITS RIGHTS OR REMEDIES  WITH  RESPECT TO ANY OTHER
COLLATERAL  WHICH  SECURES THE  OBLIGATIONS,  PRIOR TO  EXERCISING  ITS RIGHT OF
SETOFF WITH RESPECT TO SUCH DEPOSITS,  CREDITS OR OTHER PROPERTY OF THE BORROWER
OR ANY GUARANTOR, ARE HEREBY KNOWINGLY, VOLUNTARILY AND IRREVOCABLY WAIVED.

         9.2  Additional  Collateral  Security.  In addition  to the  collateral
described in Section 9.1 hereof, payment of the Obligations is also secured by a
first priority (subject to Liens permitted by this Agreement)  security interest
in (i) all personal  property  and fixtures of the Borrower and each  Guarantor,
(ii) assignments of all financing statements in favor of the Borrower and/or the
Guarantors in connection with its (their) purchase of accounts receivable, (iii)
all the issued  and  outstanding  Capital  Stock of each  Subsidiary  that is or
becomes a Guarantor, and (iv) all proceeds and products of the forgoing, whether
now owned or hereafter acquired, as provided in a Security Agreement executed or
to be executed and delivered by the Borrower and each Guarantor to the Bank.


                                       34


10.      MISCELLANEOUS.

         10.1  Notices.  All  notices,  requests  and  demands  to or  upon  the
respective  parties hereto to be effective shall be in writing unless  otherwise
expressly  provided  herein  and shall be deemed to have been duly given or made
when delivered by hand or by nationally recognized overnight courier service, or
by telegram or telecopy,  or when deposited in the mail addressed as follows, or
to such  address as may be  hereafter  notified  in  writing  by the  respective
parties hereto and any future holders of any Note:

         The Borrower:        IntegraMed America, Inc.
                              One Manhattanville Road
                              Purchase, New York 10577-2100
                              Att: Eugene R. Curcio, Vice President Finance and
                              Chief Financial Officer
                              Telecopy No.: 914-253-8008

         with a copy to:      Bachner, Tally, Polevoy & Misher LLP
                              380 Madison Ave.
                              New York, New York 10017
                              Attn: Sheldon E. Misher, Esq.
                              Telecopy No.: 212-682-5729

         The Bank:            Fleet Bank, National Association
                              244 Westchester Avenue
                              White Plains, New York 10604
                              Att: Thomas G. Carley, Vice President
                              Telecopy No.: 914-681-5045

         with a copy to:      Richard M. Skoller, Esq.
                              Emmet, Marvin & Martin, LLP
                              120 Broadway
                              New York, New York 10271
                              Telecopy No.: 212-238-3100

         10.2 No Waiver;  Cumulative  Remedies.  No failure to  exercise  and no
delay in  exercising,  on the part of the  Bank,  any  right,  remedy,  power or
privilege  hereunder shall operate as a waiver thereof;  nor shall any single or
partial exercise of any right, remedy, power or privilege hereunder preclude any
other or further exercise thereof or the exercise of any other right.

                                       35


         10.3 Survival of Representations  and Warranties.  All  representations
and  warranties  made  hereunder and in any document,  certificate  or statement
delivered pursuant hereto or in connection  herewith shall survive the execution
and delivery of this Agreement and the Notes.

         10.4 Payment of Expenses; Examination.

         (a) The Borrower  agrees to pay or reimburse the Bank for all its costs
and expenses (including, without limitation, the reasonable fees and expenses of
attorneys  for the Bank)  incurred in  connection  with (i) the  enforcement  or
preservation  of any rights  under this  Agreement or any Note or any other Loan
Document  or any  other  instrument  or  agreement  entered  into in  connection
herewith or therewith  including,  without  limitation,  the reasonable fees and
disbursements  of attorneys for the Bank;  (ii) any claim or action  threatened,
made or brought  against  the Bank  arising  out of or relating to any extent to
this  Agreement,  the  Security  Agreement,  any Note or Loan  Documents  or any
instrument  or  agreement  entered  into in  connection  with  the  transactions
contemplated hereby or thereby; (iii) the perfection of any security interest in
the Collateral or in the  maintenance of the  Collateral;  (iv) any amendment or
modification  of any Loan  Document;  (v) the  payment  of any tax,  assessment,
recording fee or similar  charge imposed on or with respect to the Collateral or
the filing or  recording of any Loan  Document;  (vi) any waiver of any right of
the Bank under any Loan Document and (vii) the reasonable fees and disbursements
of any counsel to the Bank  incurred  from time to time in  connection  with the
transactions contemplated by this Agreement.

         (b) The Borrower agrees that at any time and from time to time the Bank
may conduct an examination of the Borrower's books and records and the books and
records  of each  Network  Site  (subject  to  applicable  laws and  regulations
relating to patient  confidentiality).  The cost of one such examination in each
calendar year shall be borne by the Borrower; provided, that, should at any time
a Default or Event of Default shall have occurred and be continuing, the cost of
all such  examinations  shall  thereafter  be borne by the  Borrower  until such
Default or Event of Default shall have been cured or waived. The obligations set
forth in this  Section  10.4 shall be in  addition to any other  obligations  or
liabilities of the Borrower to the Bank hereunder or at common law or otherwise.
The  provisions  of this Section 10.4 shall survive the payment of the Notes and
the termination of this Agreement.

         10.5 WAIVER OF JURY TRIAL,  SET-OFF AND COUNTERCLAIM.  THE BORROWER AND
THE BANK MUTUALLY  HEREBY  KNOWINGLY,  VOLUNTARILY AND  INTENTIONALLY  WAIVE THE
RIGHT TO A TRIAL BY JURY,  AND THE BORROWER  WAIVES THE RIGHT TO  INTERPOSE  ANY
SETOFF OR  COUNTERCLAIM,  IN EACH CASE IN  RESPECT  OF ANY CLAIM  BASED  HEREON,
ARISING OUT OF,  UNDER OR IN  CONNECTION  WITH THIS  AGREEMENT OR ANY OTHER LOAN
DOCUMENTS  CONTEMPLATED  TO BE EXECUTED IN CONNECTION  HEREWITH OR ANY COURSE OF
CONDUCT, COURSE OF DEALINGS,  STATEMENTS (WHETHER VERBAL OR WRITTEN ) OR ACTIONS
OF ANY PARTY.  THIS WAIVER  CONSTITUTES  A MATERIAL  INDUCEMENT  FOR THE BANK TO
ACCEPT THIS AGREEMENT AND MAKE THE LOANS.

                                       36


         10.6 WAIVER OF AUTOMATIC  STAY. THE BORROWER  AGREES THAT, IN THE EVENT
THAT THE BORROWER,  ANY GUARANTOR OR ANY OF THE PERSONS OR PARTIES  CONSTITUTING
THE  BORROWER  OR ANY  GUARANTOR  SHALL  (i) FILE WITH ANY  BANKRUPTCY  COURT OF
COMPETENT  JURISDICTION  OR BE THE SUBJECT OF ANY PETITION UNDER TITLE 11 OF THE
U.S. CODE, AS AMENDED  ("BANKRUPTCY CODE"), (ii) BE THE SUBJECT OF ANY ORDER FOR
RELIEF  ISSUED UNDER THE  BANKRUPTCY  CODE,  (iii) FILE OR BE THE SUBJECT OF ANY
PETITION SEEKING ANY  REORGANIZATION,  ARRANGEMENT,  COMPOSITION,  READJUSTMENT,
LIQUIDATION,  DISSOLUTION, OR SIMILAR RELIEF UNDER ANY PRESENT OR FUTURE FEDERAL
OR STATE ACT OR LAW  RELATING TO  BANKRUPTCY,  INSOLVENCY,  OR OTHER  RELIEF FOR
DEBTORS,  (iv) HAVE SOUGHT OR CONSENTED TO OR ACQUIESCED IN THE  APPOINTMENT  OF
ANY TRUSTEE, RECEIVER,  CONSERVATOR, OR LIQUIDATOR, OR (v) BE THE SUBJECT OF ANY
ORDER,  JUDGMENT,  OR  DECREE  ENTERED  BY ANY COURT OF  COMPETENT  JURISDICTION
APPROVING  A  PETITION   FILED  AGAINST  SUCH  PARTY  FOR  ANY   REORGANIZATION,
ARRANGEMENT,  COMPOSITION,  READJUSTMENT,  LIQUIDATION,  DISSOLUTION, OR SIMILAR
RELIEF  UNDER ANY  PRESENT  OR FUTURE  FEDERAL OR STATE ACT OR LAW  RELATING  TO
BANKRUPTCY,  INSOLVENCY,  OR RELIEF FOR  DEBTORS,  THE BANK SHALL  THEREUPON  BE
ENTITLED AND THE BORROWER  IRREVOCABLY  CONSENTS TO IMMEDIATE AND  UNCONDITIONAL
RELIEF FROM ANY AUTOMATIC STAY IMPOSED BY SECTION 362 OF THE BANKRUPTCY CODE, OR
OTHERWISE,  ON OR AGAINST  THE  EXERCISE  OF THE RIGHTS AND  REMEDIES  OTHERWISE
AVAILABLE TO THE BANK AS PROVIDED FOR HEREIN,  IN ANY NOTE, OTHER LOAN DOCUMENTS
DELIVERED  IN  CONNECTION  HEREWITH  AND AS  OTHERWISE  PROVIDED BY LAW, AND THE
BORROWER HEREBY  IRREVOCABLY  WAIVES ANY RIGHT TO OBJECT TO SUCH RELIEF AND WILL
NOT CONTEST ANY MOTION BY THE BANK SEEKING  RELIEF FROM THE  AUTOMATIC  STAY AND
THE BORROWER WILL COOPERATE WITH THE BANK, IN ANY MANNER  REQUESTED BY THE BANK,
IN ITS EFFORTS TO OBTAIN RELIEF FROM ANY SUCH STAY OR OTHER PROHIBITION.

         10.7 LIMITATION OF LIABILITY. NO CLAIM MAY BE MADE BY THE BORROWER, ANY
GUARANTOR,  ANY SPECIFIED  PERSON,  OR ANY OTHER PERSON  AGAINST THE BANK OR THE
AFFILIATES,  DIRECTORS, OFFICERS, EMPLOYEES, ATTORNEYS OR AGENTS OF THE BANK FOR
ANY  SPECIAL,  INDIRECT  OR  CONSEQUENTIAL  DAMAGES  OR, TO THE  FULLEST  EXTENT
PERMITTED BY LAW,  FOR ANY PUNITIVE  DAMAGES IN RESPECT OF ANY CLAIM OR CAUSE OF
ACTION  (WHETHER  BASED ON CONTRACT,  TORT,  STATUTORY  LIABILITY,  OR ANY OTHER
GROUND)  BASED  ON,  ARISING  OUT OF OR  RELATED  TO ANY  LOAN  DOCUMENT  OR THE
TRANSACTIONS  CONTEMPLATED  HEREBY  OR  THEREBY  OR ANY ACT,  OMISSION  OR EVENT
OCCURRING IN CONNECTION THEREWITH, AND THE BORROWER (FOR ITSELF AND ON BEHALF OF
EACH  GUARANTOR AND EACH SPECIFIED  PERSON)  HEREBY WAIVES,  RELEASES AND AGREES
NEVER TO SUE UPON ANY CLAIM FOR ANY SUCH DAMAGES,  WHETHER SUCH CLAIM NOW EXISTS
OR HEREAFTER  ARISES AND WHETHER OR NOT IT IS NOW KNOWN OR SUSPECTED TO EXIST IN
ITS FAVOR.

                                       37


         10.8  Modification  and Waiver.  No  modification or waiver of, or with
respect  to any  provision  of this  Agreement  or any  document  or  instrument
delivered in connection  therewith shall be effective  unless and until it shall
be in writing and signed by the Bank, and then such modification or waiver shall
be effective only in the specific  instance and for the purpose for which given.
No notice to or demand on the Borrower in any case shall, of itself,  entitle it
to any other or further notice or demand in similar or other circumstances.

         10.9  Successors and Assigns.  (a) This Agreement shall be binding upon
and inure to the benefit of the Borrower,  the Bank,  all future  holders of the
Notes and their respective successors and assigns,  except that the Borrower may
not assign or transfer any of its rights under this Agreement  without the prior
written  consent of the Bank.  The term "Bank" as used herein shall be deemed to
include the Bank and its successors, endorsees and assigns.

         (b) The Bank shall have the unrestricted right at any time or from time
to time,  and  without  Borrower's  or any  Guarantor's  consent,  to assign any
portion  (equivalent  to an  initial  Commitment  and/or  Loans of not less than
$1,000,000 in principal  amount) of its rights and obligations  hereunder to one
or more banks or other  financial  institutions  (each,  an "Assignee")  and the
Borrower  and  each  Guarantor  agree  that it  shall  execute,  or  cause to be
executed,  such  documents,  including  without  limitation,  amendments to this
Agreement and to any other  documents,  instruments  and agreements  executed in
connection herewith as the Bank shall deem necessary to effect the foregoing. In
addition,  at the request of the Bank and any such Assignee,  the Borrower shall
issue one or more new promissory notes, as applicable, to any such Assignee and,
if the Bank has retained any of its rights and obligations  hereunder  following
such  assignment,  to the Bank,  which new  promissory  notes shall be issued in
replacement  of,  but  not in  discharge  of,  the  liability  evidenced  by the
promissory  note held by the Bank prior to such assignment and shall reflect the
amount of the  respective  commitments  and loans held by such  Assignee and the
Bank after giving effect to such assignment.  Upon the execution and delivery of
appropriate  assignment  documentation,  amendments and any other  documentation
required  by the Bank in  connection  with such  assignment,  and the payment by
Assignee of the purchase price agreed to by the Bank,  and such  Assignee,  such
Assignee shall be a party to this Agreement and shall have all of the rights and
obligations  of the Bank  hereunder  (and  under any and all  other  guaranties,
documents,  instruments and agreements  executed in connection  herewith) to the
extent that such rights and obligations  have been assigned by the Bank pursuant
to the assignment documentation between the Bank and such Assignee, and the Bank
shall  be  released  from  its   obligations   hereunder  and  thereunder  to  a
corresponding  extent.  Notwithstanding  the  foregoing,  no  Assignee  or other
transferee  of any rights of the Bank shall be  entitled  to receive any greater
payment  under  Section  2.6 or 2.13 than the Bank would have been  entitled  to
receive with respect to the rights transferred, unless such transfer was made at
a time when the circumstance giving rise to such greater payment did not exist.

         (c) The Bank  shall  have the  unrestricted  right at any time and from
time to time,  and  without  the  consent  of or notice to the  Borrower  or any
Guarantor,  to grant to one or more banks or other financial institutions (each,
a  "Participant")  participating  interests  in the  Bank's  obligation  to lend
hereunder  and/or  any or all of the Loans  held by the Bank  hereunder.  In the
event  of  any  such  grant  by  the  Bank  of  a  participating  interest  to a
Participant,  whether or not upon notice to the Borrower,  the Bank shall remain
responsible for the  performance of its  obligations  hereunder and the Borrower
shall continue to deal solely and directly with the Bank in connection  with the
Bank's rights and  obligations  hereunder.  The Bank may furnish any information
concerning  the  Borrower  in its  possession  from time to time to  prospective
Assignees  and  Participants,  provided  that the Bank  shall  require  any such
prospective  Assignee  or  Participant  to  agree in  writing  to  maintain  the
confidentiality of such information. Notwithstanding the foregoing, the Bank and
any  Participants  shall not be entitled to receive  any greater  payment  under
Section  2.6 or 2.13 than the Bank would have been  entitled  to receive  had no
participating interests been granted.

                                       38


         10.10 Governing Law; Consent to Jurisdiction. This Agreement, the Notes
and any documents and instruments delivered in connection herewith and therewith
and the rights and  duties of the  parties  hereunder  and  thereunder  shall be
governed by, and construed and  interpreted  in accordance  with, the law of the
State of New York and the Borrower consents to the jurisdiction of the courts of
the State of New York in any action  brought  to enforce  any rights of the Bank
under this Agreement and any document or instrument related hereto.

         10.11  Entire  Agreement.  This  Agreement  and any  other  agreements,
documents and  instruments  executed and delivered  pursuant to or in connection
with the Obligations  contain the entire agreement  between the parties relating
to the subject matter hereof and thereof.  The Borrower  expressly  acknowledges
that  the  Bank  has not  made  and the  Borrower  is not  relying  on any  oral
representations, agreements or commitments of the Bank or any officer, employee,
agent or representative thereof.

         10.12  Interest   Adjustment.   All  agreements  between  Borrower  and
Guarantors and the Bank are hereby  expressly  limited so that in no contingency
or event  whatsoever,  whether  by reason of  acceleration  of  maturity  of the
indebtedness  evidenced hereby or otherwise,  shall the amount paid or agreed to
be paid to the Bank for the use or the forbearance of the indebtedness evidenced
hereby exceed the maximum  permissible under applicable law. As used herein, the
term  "applicable  law"  shall  mean the law in  effect  as of the  date  hereof
provided,  however, that in the event there is a change in the law which results
in a higher  permissible  rate of  interest,  then the Loan  Documents  shall be
governed  by such  new law as of its  effective  date.  In  this  regard,  it is
expressly  agreed  that  it is the  intent  of  Borrower  and  the  Bank  in the
execution,  delivery  and  acceptance  of this  Agreement  to contract in strict
compliance  with the laws of the State of New York from time to time in  effect.
If, under or from any  circumstances  whatsoever,  fulfillment  of any provision
hereof  or of any of the  Loan  Documents  at the  time of  performance  of such
provision  shall be due, shall involve  transcending  the limit of such validity
prescribed  by  applicable  law,  then  the  obligation  to be  fulfilled  shall
automatically  be reduced to the limits of such  validity,  and if under or from
circumstances  whatsoever  the Bank should ever  receive as interest  and amount
which would exceed the highest lawful rate, such amount which would be excessive
interest shall be applied to the reduction of the principal balance evidenced by
a Note (in such manner as the Bank may determine in its sole discretion) and not
to the payment of interest.  This provision  shall control every other provision
of all agreements between the Borrower, Guarantors and the Bank.

         10.13 Pledge to Federal Reserve. The Bank may at any time pledge all or
any portion of its rights under the loan documents  including any portion of the
promissory  note to any of the twelve (12) Federal Reserve Banks organized under
Section 4 of the Federal  Reserve Act, 12 U.S.C.  Section 341. No such pledge or
enforcement  thereof  shall release Bank from its  obligations  under any of the
loan documents.

         10.14 Lost Notes.  Upon  receipt of an  affidavit  of an officer of the
Bank as to the loss,  theft,  destruction or mutilation of any Note or any other
security  document which is not of public  record,  and, in the case of any such
loss, theft, destruction or mutilation,  upon surrender and cancellation of such
Note or other security  document,  the Borrower will issue,  in lieu thereof,  a
replacement Note or other security document in the same principal amount thereof
and otherwise of like tenor.

         10.15  Counterparts.  This  Agreement  may be signed  in any  number of
counterparts  with the same effect as if the signatures  thereto and hereto were
upon the same instrument.

         IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
duly  executed  and  delivered  in New York,  New York by their  proper and duly
authorized officer as of the day and year first above written.

                            INTEGRAMED AMERICA, INC.

                             By:    /s/Eugene R. Curcio
                                    ---------------------------
                             Name:  Eugene R. Curcio
                             Title: Vice President, Finance and
                                    Chief Financial Officer


                        FLEET BANK, NATIONAL ASSOCIATION

                             By:   /s/Thomas G. Carley
                                   -----------------------------
                             Name: Thomas G. Carley
                            Title: Vice President






                                    EXHIBIT A


                    FORM OF FACILITY A REVOLVING CREDIT NOTE






                        FACILITY A REVOLVING CREDIT NOTE

$4,000,000.00                                            White Plains, New York
                                                         September 11, 1998

         INTEGRAMED AMERICA, INC., a Delaware corporation (the "Borrower"),  for
value  received,  hereby  promises to pay to the order of FLEET  BANK,  NATIONAL
ASSOCIATION  (the  "Bank")  on  September  11,  2001,  at the office of the Bank
specified in Section 10.1 of the Loan Agreement  dated as of September 11, 1998,
between the Borrower  and the Bank,  as amended from time to time (as so amended
the  "Agreement";  terms  defined in the  Agreement  shall  have  their  defined
meanings  when used in this  Note),  in  lawful  money of the  United  States of
America and in immediately  available funds the principal amount of FOUR MILLION
and 00/100 DOLLARS  ($4,000,000.00)  or, if less than such principal amount, the
aggregate  unpaid principal amount of all Loans made by the Bank to the Borrower
pursuant to Section 2.1(a) of the Agreement.  The Borrower  further  promises to
pay  interest  in like money on the unpaid  principal  balance of this Note from
time to time outstanding at an annual rate as selected by the Borrower  pursuant
to the terms of Section 2.2 of the Agreement.  Interest shall be computed on the
basis of a 360-day year for actual days elapsed and shall be payable as provided
in the  Agreement.  All Loans made by the Bank pursuant to subsection  2.1(a) of
the Agreement  and all payments of the principal  thereon may be endorsed by the
holder of this Note on the schedule annexed hereto,  to which the holder may add
additional  pages.  The  aggregate  net unpaid amount of Loans set forth in such
schedule shall be presumed to be the principal balance hereof.  After the stated
or any  accelerated  maturity  hereof,  this  Note  shall  bear  interest  at an
increased rate as set forth in the Agreement, payable on demand, but in no event
in excess of the maximum rate of interest permitted under applicable law.

         This Note is the  Facility A Revolving  Credit Note  referred to in the
Agreement,  and is entitled to the benefits  thereof and may be prepaid,  and is
required to be prepaid,  in whole or in part (subject to the indemnity  provided
in the Agreement) as provided therein. Upon the occurrence of any one or more of
the Events of Default  specified in the  Agreement,  all amounts then  remaining
unpaid  on this  Note may be  declared  to be  immediately  due and  payable  as
provided in the Agreement.  This Note is secured by the collateral  described in
each Security Agreement.

         This Note shall be  construed  in  accordance  with and governed by the
laws of the State of New York.

                                       INTEGRAMED AMERICA, INC.


                                        By:  /s/Eugene R. Curcio
                                             ---------------------------
                                      Name:  Eugene R. Curcio
                                     Title:  Vice President Finance and
                                             Chief Financial Officer






                                    EXHIBIT B


                    FORM OF FACILITY B REVOLVING CREDIT NOTE







                        FACILITY B REVOLVING CREDIT NOTE

$5,000,000.00                                             White Plains, New York
                                                          September 11, 1998

         INTEGRAMED AMERICA, INC., a Delaware corporation (the "Borrower"),  for
value  received,  hereby  promises to pay to the order of FLEET  BANK,  NATIONAL
ASSOCIATION  (the  "Bank")  on  September  11,  2001,  at the office of the Bank
specified in Section 10.1 of the Loan Agreement  dated as of September 11, 1998,
between the Borrower  and the Bank,  as amended from time to time (as so amended
the  "Agreement";  terms  defined in the  Agreement  shall  have  their  defined
meanings  when used in this  Note),  in  lawful  money of the  United  States of
America and in immediately  available funds the principal amount of FIVE MILLION
and 00/100 DOLLARS  ($5,000,000.00)  or, if less than such principal amount, the
aggregate  unpaid principal amount of all Loans made by the Bank to the Borrower
pursuant to Section 2.1(b) of the Agreement.  The Borrower  further  promises to
pay  interest  in like money on the unpaid  principal  balance of this Note from
time to time outstanding at an annual rate as selected by the Borrower  pursuant
to the terms of Section 2.2 of the Agreement.  Interest shall be computed on the
basis of a 360-day year for actual days elapsed and shall be payable as provided
in the  Agreement.  All Loans made by the Bank pursuant to subsection  2.1(b) of
the Agreement  and all payments of the principal  thereon may be endorsed by the
holder of this Note on the schedule annexed hereto,  to which the holder may add
additional  pages.  The  aggregate  net unpaid amount of Loans set forth in such
schedule shall be presumed to be the principal balance hereof.  After the stated
or any  accelerated  maturity  hereof,  this  Note  shall  bear  interest  at an
increased rate as set forth in the Agreement, payable on demand, but in no event
in excess of the maximum rate of interest permitted under applicable law.

         This Note is the  Facility B Revolving  Credit Note  referred to in the
Agreement,  and is entitled to the benefits  thereof and may be prepaid,  and is
required to be prepaid,  in whole or in part (subject to the indemnity  provided
in the Agreement) as provided therein. Upon the occurrence of any one or more of
the Events of Default  specified in the  Agreement,  all amounts then  remaining
unpaid  on this  Note may be  declared  to be  immediately  due and  payable  as
provided in the Agreement.  This Note is secured by the collateral  described in
each Security Agreement.

         This Note shall be  construed  in  accordance  with and governed by the
laws of the State of New York.

                                       INTEGRAMED AMERICA, INC.


                                        By:  Eugene R. Curcio
                                             ----------------------------
                                      Name:  Eugene R. Curcio
                                     Title:  Vice President Finance and
                                             Chief Financial Officer







                                    EXHIBIT C

                                FORM OF TERM NOTE







                                    TERM NOTE


$4,000,000.00                                          White Plains, New York
                                                       September 11, 1998


                INTEGRAMED   AMERICA,   INC.,   a  Delaware   corporation   (the
"Borrower"),  for value  received,  hereby promises to pay to the order of FLEET
BANK, NATIONAL  ASSOCIATION (the "Bank") at its office specified in Section 10.1
of the Loan  Agreement  dated as of September  11, 1998 between the Borrower and
the Bank,  as amended  from time to time (as so amended the  "Agreement";  terms
defined in the  Agreement  shall have their  defined  meanings when used in this
Note) in lawful money of the United States and in immediately  available  funds,
the principal sum of FOUR MILLION AND 00/100 DOLLARS  ($4,000,000.00) payable in
sixteen (16)  consecutive  quarterly  installments  in the amount of $250,000.00
each and the last  and  final  installment  equal to the then  unpaid  principal
balance of this Note payable on the first day of each , January, March, June and
September,  commencing  June 1,  2000.  The  Borrower  further  promises  to pay
interest  at said office in like money on the unpaid  principal  balance of this
Note from time to time outstanding  (computed on the basis of a 360 day year for
actual days  elapsed) at an annual rate as selected by the Borrower  pursuant to
the terms of Section 2 of the  Agreement.  Interest shall be payable as provided
in the  Agreement.  Whenever  the entire  unpaid  principal  amount of this Note
becomes due and payable (whether at the stated maturity hereof,  by acceleration
or otherwise) interest hereon shall thereafter be payable on demand at a rate as
set forth in the  Agreement,  but in no event in excess of the  maximum  rate of
interest permitted under any applicable law.

                This Note is the Term Note referred to in the Agreement,  and is
entitled to the benefits and subject to the terms  thereof and may be prepaid in
whole  or in part  (subject  to the  indemnity  provided  in the  Agreement)  as
provided  therein.  This Note is secured  by the  Collateral  described  in each
Security Agreement.

                Upon the  occurrence of any one or more of the Events of Default
specified in the Agreement,  all amount then remaining unpaid under the Note may
be declared immediately due and payable as provided in the Agreement.

                This Note shall be construed in accordance  with and governed by
the laws of the State of New York.

                                               INTEGRAMED AMERICA, INC.


                                         By:  /s/Eugene R. Curcio
                                              ----------------------------
                                       Name:  Eugene R. Curcio
                                      Title:  Vice President Finance and
                                              Chief Financial Officer