EXHIBIT 4(f)


                           KARDATZKE MANAGEMENT, INC.

                       INTEGRATED MEDICAL RESOURCES, INC.

                             Note Purchase Agreement


     This Note Purchase  Agreement (this "Agreement") dated as of March 5, 1998,
is  entered  into  between  Kardatzke  Management,  Inc.  or its  designee  (the
"Purchaser") and Integrated Medical Resources, Inc. (the "Company").

                              W I T N E S S E T H:

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

     1.       Purchase and Sale of Note.

     Subject  to and in  accordance  with  the  terms  and  conditions  of  this
Agreement,  at the Closing  (as defined in Section 2), the Company  will sell to
the Purchaser,  and Purchaser will purchase, a subordinated  convertible note of
the Company (the "Note") for the purchase price of $1,600,000.  The principal of
the Note and interest thereon shall be convertible into shares (the "Shares") of
the Company's common stock,  $.001 par value per share (the "Common Stock"),  in
accordance with the terms and provisions of the Note.

     2.       Closing.

                    (a)  The closing of the sale and  purchase of the Note under
this  Agreement (the  "Closing")  shall take place on the date of this Agreement
(the "Closing  Date")  and  shall   be   consummated  by   facsimile  or mail in
accordance with arrangements  reasonably  acceptable  to counsel for the Company
and counsel for the Purchaser. 

                    (b)   At  the  Closing: 

                            (i)  The  Purchaser  will  furnish  payment  to  the
Company of the purchase  price for the Note by wire transfer or any other method
acceptable to the  Purchaser  and the Company,  and the Company will execute and
deliver to the Purchaser the Note in substantially the form of Exhibit A hereto.

                            (ii) The  Company  will pay the  Purchaser,  by wire
transfer,  up to an  aggregate  of  $35,000  of  its  documented,  out-of-pocket
expenses and legal fees and related  expenses  incurred in  connection  with its
investment determination review of the Company.


 




                            (iii) The Company and the Purchaser will execute and
deliver to each other  counterparts of a consulting  agreement in  substantially
the form of Exhibit B hereto (the "Consulting Agreement").

                            (iv) The Company's  counsel will execute and deliver
to the Purchaser a legal opinion substantially in the form of Exhibit C hereto.

                            (v)  The  Company's  chief  executive   officer  and
secretary will execute and deliver to the Purchaser  certificates  substantially
in the forms of the Exhibits D and E hereto, respectively.

                            (vi) The  Company  will  deliver to the  Purchaser a
certificate of the Kansas Secretary of State with respect to the Company,  as of
a recent date,  stating that the Company is validly existing as a corporation in
good standing in such state.

                            (vii) The Company will deliver Exhibit F hereto.

         3.  Representations  of the Company.  The Company hereby represents and
warrants to the Purchaser that:

                    (a)  The  Company is duly incorporated, validly existing and
in good standing under the laws of the State of Kansas.

                    (b)   The Company has full corporate power  and authority to
enter  into  and perform its obligations under this Agreement, the Note and  the
Consulting Agreement.

                    (c)   The execution, delivery and performance by the Company
of this  Agreement,  the  Note  and  the  Consulting   Agreement  have been duly
authorized  by  all  necessary  corporate  action  on  the  part of the Company;
provided, however, it is understood  by the  parties that the  conversion of any
Notes or Securities of the  Company  for  20% or more of the outstanding  shares
will  require  the  approval  of  the Company's shareholders, which approval the
Company agrees to use its best efforts to obtain; and this  Agreement,  the Note
and  the  Consulting  Agreement  have  been  duly  executed and delivered by the
Company.

                     (d)   All  corporate  action  on  the  part  of the Company
necessary for, and all consents, approvals, authorizations  of or  filings  with
any  person or government authority required for, the authorization,  execution,
delivery and performance  by the  Company of this  Agreement,  the Note  and the
Consulting  Agreement  and the  consummation  of the  transactions  contemplated
herein and therein, and  for  the  authorization,  offer,   issuance,  sale  and
delivery of the Note and  the  Shares   issuable  upon  conversion  of the Note,
has been taken or procured,  as  the  case  may  be;  provided, however,  it  is
understood by the parties that the conversion of any notes (including this Note)
or  securities of the Company  for  20% or more of the  outstanding  shares will
require the approval of the Company's shareholders,  which  approval the Company
agrees to use its best efforts to obtain. This  Agreement,  the   Note  and  the
Consulting Agreement are the  valid  and  binding  obligations  of  the Company,
enforceable against the Company  in  accordance  with  their  respective  terms,
except as such  enforceability  may be limited by or 





                                        2





subject to any  bankruptcy,  insolvency,  reorganization,  moratorium or similar
laws affecting the enforcement of creditors'  rights  generally,  and subject to
general  principles of equity.  The Shares  issuable upon conversion of the Note
have  been  duly and  validly  reserved  for  issuance  and,  upon  issuance  in
accordance with the terms of the Note,  will be validly  issued,  fully paid and
nonassessable.

                     (e)   The  authorized capital stock of the Company consists
of 10,000,000  shares  of  Common   Stock  and  3,000,000  shares  of  Preferred
Stock,  of  which  Preferred  Stock  there  are  authorized   1,081,080   shares
designated as Series A Preferred Stock, $.001 par value per share (the "Series A
Preferred Stock"), and  222,222  shares  designated as Series B Preferred Stock,
$.001 par value per share  (the "Series B Preferred"  Stock).  Immediately prior
to the Closing,  6,731,058  shares  of  Common  Stock,  and 0 shares of Series A
Preferred  Stock, and 0 shares  of  Series  B Preferred Stock will be issued and
outstanding.

                      Except  as  specified above, or in Exhibit G hereto, there
are no outstanding preemptive,  conversion or other rights, options, warrants or
agreements granted  or  issued by or binding  upon the Company for the  issuance
of any shares of its capital stock.

                     (f)   Except  as  waived prior to the Closing, the Note and
the Consulting Agreement,  and compliance herewith and therewith, and the offer,
issuance, sale  and  delivery of the Note and the Shares will not, result in any
violation of and will not conflict  with, or  result  in a breach  of any of the
terms of, or constitute a default under,  any provisions of federal or state law
to  which  the  Company  is subject, the Company's Articles of Incorporation, as
amended  (subject  to  shareholder  approval of an amendment to the  Articles of
Incorporation  to increase  the  amount  of authorized  shares),  the  Company's
By-Laws  or any mortgage, indenture,  agreement,  instrument,  judgment, decree,
order, rule or regulation or other  restriction  to which the Company is a party
or by which it is bound or result in the creation of any mortgage, pledge, lien,
encumbrance  or  charge  upon  any  of  the  properties or assets of the Company
pursuant to any such term.

                     (g)   The  Company  has  no  outstanding  indebtedness  for
borrowed  money  except as set forth in Exhibit H hereto.  The Company is not in
default with respect to any indebtedness for borrowed money.

                     (h)   The  Company  has  filed  all tax returns and reports
required to be  filed  with the United States Internal Revenue Service, with the
State of Kansas, and with all other jurisdictions where such filing is  required
by law.  The Company has paid or, as and to the  extent  required  by  generally
accepted  accounting   principles,  made adequate provisions for the payment of,
all taxes, interest,  penalties,  assessments or deficiencies shown to be due or
claimed to be due on or in respect of such tax returns and reports.

                     (i)   Other than as set forth in Exhibit I hereto, there is
neither pending nor, to the Company's knowledge,  threatened,  any action, suit,
proceeding or claim,  or outstanding orders, judgments,  injunctions,  awards or
decrees  of  any  court,  regulatory body or arbitration  tribunal, to which the
Company is or may be  named  as a party  or its  property  is or may be  subject
and in which an unfavorable outcome, ruling or finding in any such matter or 




                                        3





for all such matters  taken as a whole might have a material  adverse  effect on
the financial condition or operations of the Company.

                     (j)   The Company has a  good  and valid ownership interest
in all of its property  and  assets, free from  all mortgages,  pledges,  liens,
security  interests,  conditional  sale   agreements,  encumbrances  or charges,
except as  listed  on Exhibit J hereto.  The Company does not have any ownership
interest in real  property. Except as listed on Exhibit I, the Company is not in
violation of any  law,  regulation  or ordinance  (including  laws,  regulations
or ordinances  relating to building, zoning, environmental,  city planning, land
use or similar matters)  relating  to its  property  or assets  which  violation
would have a material adverse effect on the financial condition or operations of
the Company.

                     (k)   The Company has all franchises, permits, licenses and
other  similar  authority,  and  is  duly  qualified  or  licensed  as a foreign
corporation  in  each  jurisdiction  in  which is required to be so qualified or
licensed,  necessary for  the  conduct  of its  business as  conducted  by it or
proposed  to  be   conducted  by  it, the  lack of which  could  materially  and
adversely  affect  the  financial  condition  or  operations  of the Company and
is not in default in any  material  respect   under   any  of  such  franchises,
permits,  licenses  or  other  similar authority.  Each of the material patents,
patent rights,  trademarks,  trademark rights, trade names,  trade name  rights,
copyrights,  proprietary  rights and processes owned or used by the Company (the
"Technology")  is valid and in good  standing  and (taken as a whole) reasonably
adequate  and sufficient to permit the  Company  to  conduct  its   business  as
conducted by it or proposed to be conducted  by  it   without,  to the Company's
knowledge,   conflict  with or infringement upon  any  valid  rights  of  others
The Company is not aware of and has not received any notice of infringement upon
or conflict with the asserted rights of others.

                     (l)   The  Company is not in  violation  of any term of its
Certificate  of  Incorporation,  as  amended,  or its By-Laws.  Except as listed
on Exhibit I, the Company is not in violation of any term of any law,  judgment,
decree, order, rule or regulation, mortgage,  indenture,  agreement,  instrument
or  other  restriction  to which the Company is subject and a violation of which
would have a material adverse effect on the financial  condition  or  operations
of the Company.
                     (m)    The Company  does  not maintain any employee pension
benefit plan as defined in Section 3(2)(A) of Title I of the Employee Retirement
Income Security Act of 1974, as amended.

                     (n)    The Company is  not  in  violation of any applicable
federal,  state  or  local  statute,  law  or  regulation,  including  any  such
statutes,  laws  or  regulations relating to the environment,  which violations,
either singly or in  the aggregate,  would have a material adverse effect on the
Company's  financial condition or results of operations, and reasonably believes
that no material expenditures are  or  will  be required in order to comply with
any such  statute, law or regulation.

                     (o)    The  Company  is  insured  by reputable insurers its
assets that are of an  insurable character against risks of liability (including
product  liability),  casualty  and fire in




                                        4





adequate  and  customary  amounts for  similarly  situated  companies in similar
businesses.  The Company carries no self-insurance  risk for any employee health
or worker's  compensation risk. Exhibit K hereto sets forth a true, complete and
correct list of the Company's  insurance  policies,  including policy limits and
deductibles.  The  Company's  insurance  coverage is customary  for well insured
corporations of similar size engaged in similar lines of business.

                     (p)    To  the  Company's  knowledge,  none  of its current
executive officers has been convicted of any crime constituting a felony.

                     (q)    The   Company  is not an "investment company" within
the meaning of the Investment Company Act of 1940.

                     (r)     Assuming  the  accuracy  of the representations and
warranties set forth in Section 4, the offer,  sale and issuance of the Note and
the Shares hereunder do not  require  registration under the  Securities  Act of
1933  (the  "Act"), registration  or  qualification  under any applicable  state
securities laws or qualification of an indenture under the Trust  Indenture  Act
of 1939.

         4.  Representations  of the  Purchaser.  The Purchaser  represents  and
warrants to the Company as follows:

                     (a)    It   is  acquiring  the  Note  and  the  Shares  for
investment for its own  account  and  not with a view to the resale, transfer or
other disposition thereof and any sale or disposition  of the Note or the Shares
will be made only if the Note or the Shares are registered  under the Act or the
sale or  disposition is  made  in compliance with an exemption  under the Act or
the rules thereunder and any applicable state  securities  laws. It  understands
that the Note and the Shares have not been registered under the Act by reason of
specified  exemptions from the registration provisions of the Act.

                     (b)    (i)   It  acknowledges  that the Note and the Shares
must be held indefinitely unless they  are  subsequently  registered  under  the
Act or an exemption from such registration is available.  It has been advised or
is aware  of  the  provisions  of Rules 144 and 144A promulgated  under the Act,
which permit the resale of securities purchased in a private  placement  subject
to  the  satisfaction  of  certain  conditions  and  that  such Rules may not be
available for sale of the Note and the Shares.

                            (ii)  It    acknowledges   that   all   certificates
representing  the  Note  and  the  Shares  will have endorsed thereon legends in
substantially the following form:

            THESE SECURITIES  HAVE  NOT BEEN REGISTERED UNDER THE
            SECURITIES ACT OF 1933 OR QUALIFIED UNDER  APPLICABLE
            STATE SECURITIES LAWS.  UNLESS THEY ARE SOLD PURSUANT
            TO  RULE  144A  OR  RULE  144   PROMULGATED   BY  THE
            SECURITIES  AND EXCHANGE  COMMISSION  UNDER SAID ACT,
            THEY  MAY  NOT BE SOLD OR  OTHERWISE  TRANSFERRED  IN
            ABSENCE  OF  SUCH   REGISTRATION  AND   QUALIFICATION
            WITHOUT AN





                                        5





            OPINION  OF  COUNSEL  FOR  THE   HOLDER,   REASONABLY
            SATISFACTORY  TO COUNSEL FOR THE  COMPANY,  THAT SUCH
            REGISTRATION AND QUALIFICATION ARE NOT REQUIRED.

            THE SECURITIES  REPRESENTED BY THIS  CERTIFICATE  ARE
            SUBJECT  TO   CERTAIN   RESTRICTIONS   AGAINST   SALE
            CONTAINED  IN A CERTAIN  AGREEMENT  BETWEEN AND AMONG
            THE REGISTERED  OWNER OF THIS CERTIFICATE AND CERTAIN
            OTHER HOLDERS OF THE CORPORATION,  AND A COPY OF SAID
            AGREEMENT  IS  AVAILABLE  FOR   INSPECTION,   WITHOUT
            CHARGE, AT THE OFFICES OF THE CORPORATION.

Such legend shall be removed by the Company upon delivery to it of an opinion of
counsel to the  Company  (which  opinion  and  counsel  rendering  same shall be
reasonably  satisfactory to the Company) that a registration statement under the
Act is at the time  effective  with  respect  to the  transfer  of the  legended
security or that such  security may be  transferred  without  such  registration
statement  being in  effect  and  without  the  requirements  of a legend on the
certificate in the hands of the transferee.

                     (c)   It has had an  opportunity  to  discuss the Company's
business, management  and  financial affairs with its management and has had the
opportunity to review  the Company's  facilities.  It is not subscribing for the
Note and the Shares as a result of or subsequent to any advertisement,  article,
notice or other communication  published in any  newspaper,  magazine or similar
media   or   broadcast   over   television   or   radio   or any solicitation of
a subscription   by  a  person  not  previously   known to it in connection with
investments in securities generally.

                     (d)   It has  full power and authority to enter into and to
perform this  Agreement in accordance with its terms.  All action  (corporate or
otherwise) on  the  part  of  the  Purchaser  necessary  for  the authorization,
execution,  delivery and  performance by the Purchaser of this Agreement and the
consummation  of  the  transactions  contemplated  herein  has  been taken. This
Agreement is a valid and  binding  obligation  of the Purchaser,  enforceable in
accordance with its terms, except as  such  enforceability  may be limited by or
subject to any  bankruptcy,  insolvency,  reorganization,  moratorium or similar
laws affecting the enforcement of  creditors'  rights  generally, and subject to
general principles of equity.

                     (e)    It has been advised or is aware of the provisions of
Regulation  D   promulgated  under  the  Act  relating  to  the accreditation of
investors,  and it is an "accredited investor" as defined in Regulation D.

         5.       Transfers.

                     (a)    The  Purchaser agrees that it shall give the Company
prior written notice  of any proposed transfer of the Note or any of the Shares,
including the name and  address  of  the proposed transferee.  Prior to any such
proposed transfer, 





                                        6





other than pursuant to a sale under a applicable  registration  statement  under
the Act or a sale  pursuant  to Rule 144  promulgated  under  the Act,  and as a
condition  thereto,  the Purchaser will deliver to the Company (i) an investment
covenant signed by the proposed transferee substantially as set forth in Section
4(b) hereof, (ii) an agreement by such transferee to the restrictive  investment
legend set forth in Section  4(c)(ii)  hereof on the certificate or certificates
representing  the securities  acquired by such transferee and (iii) an agreement
by the  transferee  to be subject to the  provisions  of this  Agreement and the
provisions  of the  Agreement  to the same  extent  as if such  transferee  were
originally a signatory to this Agreement and the Agreement.  Any transfer of the
Note  or of any of the  Shares  attempted  contrary  to the  provisions  of this
Agreement, or any levy of execution,  attachment or other process attempted upon
the Note or any of the Shares, shall be null and void and without effect.

                    (b) In  the  event  of  any  transfer  of  the  Note  by the
Purchaser in accordance with the provisions of this Agreement,  for the purposes
of  this  Agreement,   the  subordinated   convertible   notes  of  the  Company
representing  portions of the principal  amount  originally  represented  by the
Note,  shall be referred to herein  individually as a "Note" and collectively as
the "Notes".

                    (c) In the event of the  resale of any Note or of any of the
Shares  pursuant to Rule 144A  promulgated  under the Act, the Company agrees to
comply with the information  requirements of Rule 144A(d)(4)  promulgated  under
the Act.

         6.   Covenants  of  the  Company.  The  Company  hereby  covenants  and
agrees, that so long as any of the Notes remain outstanding:

                    (a) The Company shall  deliver the following  reports to all
persons who hold any of the Notes:

                             (i) As soon as  practicable  after  the end of each
fiscal year of the Company,  and in any event,  within 135 days after the end of
each  fiscal  year,  a  consolidated  balance  sheet  of  the  Company  and  its
subsidiaries  (if  any),  as at the end of such  fiscal  year  and  consolidated
statements of income and cash flows of the Company and its subsidiaries (if any)
for such year,  setting forth in each case in  comparative  form the figures for
the previous fiscal year, all in reasonable detail and accompanied by the report
thereon of  independent  certified  public  accountants  of recognized  national
standing  and  considered  one of the "Big Six"  accounting  firms in the United
States,  selected  by the  Company,  which  report  shall  state  that  (A) such
financial  reports have been  prepared in  accordance  with  generally  accepted
accounting  principles and (B) the audit by such  accountants in connection with
such financial  statements has been made in accordance  with generally  accepted
auditing standards.

                             (ii) As soon as  practicable  after the end of each
month, using all commercially reasonable efforts to cause such delivery to occur
within 30 days after the end of such month, a consolidated  balance sheet of the
Company  and  its  subsidiaries  (if  any)  as at the  end  of  such  month  and
consolidated  statements  of  income  and  cash  flows  of the  Company  and its
subsidiaries (if any) for such month, prepared 



                                        7





in  accordance  with  generally  accepted  accounting  principles   consistently
applied,   except  for  footnote   disclosure  and  subject  to  year-end  audit
adjustments,  and  accompanied by a certificate of the Company's chief financial
officer to such effect.

                             (iii) As soon as available,  using all commercially
reasonable  efforts to cause such delivery to occur prior to December 31 of each
year, the annual operating plan of the Company for the succeeding  calendar year
including appropriate projections and underlying assumptions.

                             (iv)  With   reasonable   promptness,   such  other
information  and data with respect to the Company as the Purchaser may from time
to time reasonably request.

                      (b) Without the affirmative vote or prior written approval
of the holders of a majority of the Notes and at least a majority of the members
of  the  Board  of  Directors  of the  Company,  neither  the  Company  nor  its
subsidiaries (if any) shall, together or alone:

                             (i)  incur,  create,  assume or permit to exist any
Indebtedness  other than the Note except for (a)  indebtedness  in an amount not
exceeding  $7,800,000,  consisting of (1) $5 million under the existing  working
capital line of credit and (2) $2.8 million of long term indebtedness (including
the  current  portion  thereof);  (b)  unsecured  trade  credit  incurred in the
ordinary course of business; and (c) capitalized lease obligations not to exceed
$1,000,000.  Indebtedness  means all items which, in accordance with GAAP, would
be included on the liability side of a balance sheet,  excluding  capital stock,
surplus, capital and earned surplus.

                             (ii) lease, purchase,  sell or otherwise acquire or
dispose of any property or services  having a value in excess of $200,000 in any
transaction or series of similar transactions;

                             (iii)   assign,   mortgage,   pledge  or  otherwise
encumber any assets having a value of more than $200,000;

                             (iv) make any loan, extend any credit or forgive or
otherwise change the terms of any indebtedness, in excess of $200,000;

                             (v) make any  material  change in the  character of
its business as presently  conducted or as proposed to be conducted,  or conduct
its business in a manner other than in the normal and ordinary course;

                             (vi)  declare  or pay  any  dividend  in cash or in
property or make or authorize any other  distribution  directly or indirectly on
its Common Stock or any other capital stock now outstanding or hereafter issued;

                             (vii)  directly or  indirectly  purchase,  acquire,
redeem or retire any share of its  outstanding  capital stock or any  securities
exercisable for, or convertible into, its capital stock; or






                                        8





                             (viii)  enter  into  any   transaction  of  merger,
consolidation or reorganization,  or dissolve,  wind up or liquidate, or convey,
sell,  lease,  exchange,  transfer or otherwise  dispose of in a transaction  or
related series of  transactions  all or  substantially  all of the assets of the
Company.

                      (c) Without the affirmative vote or prior written approval
of the  holders  of a  majority  of the  Notes  and at least a  majority  of the
disinterested  directors on the Board of Directors,  neither the Company nor its
subsidiaries (if any) shall,  together or alone, enter into any transaction with
any  Affiliate  of the Company on terms that are not as favorable as the Company
could obtain from an unaffiliated third party.

                      (d) The Company  shall take all such  actions  (reasonably
within its control) so as to assure that each of its executive  officers  devote
substantially  all of  their  respective  business  time  and  attention  to the
Company's business.

         7.  Joint  Covenants.   The  Company and the Holder agree that upon the
exercise of the option pursuant to Section 6.6(a) of the  Convertible  Note they
will execute an Employee  Agreement  mutually agreed upon by the parties and the
Board will  appoint  Dr. E.  Stanley  Kardatzke  Chairman of the Board and Chief
Executive Officer of the Company.

         8.  Survival  of  Representations   and  Warranties.   All  agreements,
representations and warranties  contained herein shall survive the execution and
delivery  of this  Agreement  and the closing of the  transactions  contemplated
hereby.  All  agreements,  representations  and warranties  shall terminate upon
conversion of the Convertible Note.

         9. Expenses.  Other than as set forth in Section 2(b)(iii) hereto, each
party  hereto  shall pay its own  costs and  expenses  in  connection  with this
Agreement and the closing of the transactions contemplated hereby.

         10. Notices. All notices,  requests,  consents and other communications
under  this  Agreement  shall be in  writing  and  shall be  delivered  by hand,
recognized  courier,  mailed by first class certified or registered mail, return
receipt requested,  postage prepaid,  or delivered by telecopy to the Company or
the Purchaser, as the case may be, at the following respective addresses:

                       Kardatzke Management, Inc.
                       701 Destacada Avenue
                       Coral Gables, Florida  33156
                               Tel: (305) 663-9188
                               Fax: (305) 663-9180
                       Attention: Dr. E. Stanley Kardatzke


                                        9





                       Integrated Medical Resources, Inc.
                       11320 West 79th Street
                       Lenexa, Kansas  66214
                               Tel: (913) 962-7201
                               Fax: (913) 962-7719
                        Attention: Troy A. Burns, M.D.

                Either  party may  change its  address  for  purposes  hereof by
notice to the other party in the manner provided above.

         11.  Brokers.  Each of the Company and the  Purchaser,  with respect to
itself,  (i) represents and warrants to the other that it has retained no finder
or broker in connection with the transactions contemplated by this Agreement and
(ii) will  indemnify  and save the other  harmless  from and against any and all
claims, liabilities or obligations with respect to brokerage or finder's fees or
commissions, or consulting fees in connection with the transactions contemplated
by this  Agreement  asserted  by any  person  on the basis of any  statement  or
representation alleged to have been made by such indemnifying party.

         12. Entire Agreement.  With respect to the subject matter hereof,  this
Agreement,  including  the Exhibits  hereto,  embodies the entire  agreement and
understanding  between the Purchaser and the Company,  and  supersedes all prior
agreements and understandings relating to such subject matter.

         13. Counterparts.  This   Agreement    may   be   executed  in  several
counterparts,  each  of  which  shall be  deemed an  original,  but all of which
together  shall constitute one and the same instrument.

         14. Headings. The headings of the sections,  subsections and paragraphs
of this Agreement have been added for  convenience  only and shall not be deemed
to be a part of this Agreement.

         15.  Severability.  Any provision of this Agreement which is invalid or
unenforceable  in any  jurisdiction  shall be  ineffective to the extent of such
invalidity or unenforceability  without invalidating or rendering  unenforceable
the remaining provisions of this Agreement, and, to the extent permitted by law,
any determination of invalidity or  unenforceability  in any jurisdiction  shall
not invalidate or render unenforceable such provision in any other jurisdiction.

         16. Amendments and Waivers.  Neither this Agreement nor any term hereof
may be changed,  waived,  discharged or terminated orally or in writing,  except
that any term of this  Agreement  may be amended and the  observance of any such
term may be waived  (either  generally  or in a  particular  instance and either
retroactively or prospectively)  with (but only with) the written consent of the
Company  and the holders of Notes that  represent  in the  aggregate  at least a
majority of the total principal amount of the Notes then outstanding.








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         17.  Successors  and Assigns.  Except as otherwise  expressly  provided
herein,  the  provisions  hereof  shall  inure to the benefit of, and be binding
upon,  the  successors,  assigns,  heirs,  executors and  administrators  of the
parties hereto.

         18. Parties in Interest.  The Company and the Purchaser  agree that the
only  persons  with an interest in the  transactions  and  agreements  set forth
herein are the Company and the  Purchaser,  that no other  person shall have any
rights under this Agreement and that no other person shall be the beneficiary of
any of the rights and obligations provided by this Agreement.

         19.      Definitions.

                      (a) As used in this  Agreement,  "Affiliate"  shall  mean,
with respect to any person, any other person controlling, controlled by or under
common control with such person.  The term "control" as used in the  immediately
preceding sentence means, with respect to a corporation,  the right to exercise,
directly or  indirectly,  50% or more of the voting rights  attributable  to the
shares of the controlled corporation, or with respect to any person other than a
corporation,  the possession,  directly or indirectly, of the power to direct or
cause the direction of the management or policies of such person.

                      (b) As used in this  Agreement , the term  "person"  means
any individual,  partnership,  corporation,  limited liability  company,  trust,
unincorporated  organization  or other legal  entity,  or any  government or any
agency or political subdivision thereof.

         20.  Waiver of Jury  Trial,  etc..  The Company  and  Purchaser  hereby
knowingly,  voluntarily and  intentionally  waive (a) any right to trial by jury
the Company and  Purchaser  may have in any action or  proceeding,  in law or in
equity, in connection with this Agreement or the transactions related hereto and
(b) any right to contest  enforcement  of  provisions  of the last  sentence  of
Section 20 hereof on the basis of forum non conveniens.

         21.  Governing Law;  Jurisdiction.  This Agreement shall be governed by
and  construed  in  accordance  with the  domestic  laws of the  State of Kansas
applicable to contracts  made and to be performed in that State  without  giving
effect to any choice or conflict of law  provision or rule (whether in the State
of Kansas or any other  jurisdiction)  that would cause the  application  of the
laws of any  jurisdiction  other than the State of Kansas.  The  parties  hereto
consent to the  jurisdiction  of the State of Florida or state or federal courts
located therein for all disputes arising under this Agreement.















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         IN WITNESS WHEREOF, the undersigned have hereunto set their hands as of
the day and year first above written.

                                       "Company"
                                       INTEGRATED MEDICAL RESOURCES, INC.


 
                                       By   /s/ Troy A. Burns, M.D.
                                       ----------------------------
                                           Troy A. Burns, M.D.
                                           Chief Executive Officer


                                        "Purchaser"

                                        KARDATZKE MANAGEMENT, INC.



                                        By    /s/ E. Stanley Kardatzke, M.D.
                                        ------------------------------------
                                              E. Stanley Kardatzke, M.D.
                                        Title: Chairman




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