UNITED STATES

                       SECURITIES AND EXCHANGE COMMISSION

                             WASHINGTON, D.C. 20549


                                  SCHEDULE 13D
                  UNDER THE SECURITIES AND EXCHANGE ACT OF 1934

                            Patient Infosystems, Inc.
--------------------------------------------------------------------------------
                                (Name of Issuer)

                          Common Stock, $.001 par value
--------------------------------------------------------------------------------
                         (Title to Class of Securities)

                                    702915109
--------------------------------------------------------------------------------
                                 (CUSIP NUMBER)

                              Karen E. Shaff, Esq.
                         Principal Financial Group, Inc.
                                 711 High Street
                              Des Moines, IA 50392
--------------------------------------------------------------------------------
                  (Name, Address and Telephone Number of Person
                Authorized to Receive Notices and Communications

                                 April 11, 2003
--------------------------------------------------------------------------------
             (Date of Event Which Requires Filing of This Statement)

If the filing person has previously  filed a statement on Schedule 13G to report
the  acquisition  that is the subject of this  Schedule  13D, and is filing this
schedule because of ss.ss. 240.13d-1(e),  240.13d-1(f),  or 240.13d-1(g),  check
the following box. [ ]

NOTE:  Schedules  filed in paper format shall include a signed original and five
copies of the schedule,  including all exhibits.  See ss. 240.13d-7(b) for other
parties to whom copies are to be sent.

*The  remainder of this cover page shall be filled out for a reporting  person's
initial filing on this form with respect to the subject class of securities, and
for  any  subsequent   amendment   containing   information  which  would  alter
disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the  Securities  Exchange  Act of
1934 ("Act") or otherwise  subject to the liabilities of that section of the Act
but  shall be  subject  to all other  provisions  of the Act  (however,  see the
Notes).

CUSIP No. 70295109

                                       1


1. Names of  Reporting  Persons,  I.R.S.  Identification  Nos. of above  persons
(entities only).

Principal Financial Group, Inc.
--------------------------------------------------------------------------------

2. Check the Appropriate Box if a Member of a Group (See Instructions)

(a)  [ X  ]

(b)  [   ]

3. SEC Use Only

--------------------------------------------------------------------------------

4.  Source of Funds

                                       00
--------------------------------------------------------------------------------

5. Check Box if Disclosure of Legal  Proceedings  is Required  Pursuant to items
2(d) or 2(e)
                                                                           [   ]

6.  Citizenship or Place of Organization

                                    Delaware
--------------------------------------------------------------------------------

NUMBER OF SHARES                      7.  Sole Voting Power
BENEFICIALLY OWNED BY
EACH REPORTING PERSON
WITH
                                      ------------------------------------------

                                      8.  Shared Voting Power

                                                12,838,680
                                      ------------------------------------------

                                      9.  Sole Dispositive Power


                                      ------------------------------------------

                                      10.  Shared Dispositive Power

                                                12,838,680
                                      ------------------------------------------

11. Aggregate Amount Beneficially Owned by Each Reporting Person

                                                12,838,680
--------------------------------------------------------------------------------

                                       2


12. Check Box if the Aggregate Amount in Row (11) Excludes Certain Shares
                                                                           [   ]

13. Percent of Class Represented by Amount in Row (11)

                                     53.96%
--------------------------------------------------------------------------------

14.  Type of Reporting Person

                                       HC
--------------------------------------------------------------------------------



1. Names of  Reporting  Persons,  I.R.S.  Identification  Nos. of above  persons
(entities only).

Principal Financial Services, Inc.
--------------------------------------------------------------------------------

2. Check the Appropriate Box if a Member of a Group (See Instructions)

(a)  [ X  ]

(b)  [    ]

3. SEC Use Only

--------------------------------------------------------------------------------

4.  Source of Funds

                                       00
--------------------------------------------------------------------------------

5. Check Box if Disclosure of Legal  Proceedings  is Required  Pursuant to items
2(d) or 2(e)
                                                                           [   ]

6.  Citizenship or Place of Organization

                                      Iowa
--------------------------------------------------------------------------------

NUMBER OF SHARES                      7.  Sole Voting Power
BENEFICIALLY OWNED BY
EACH REPORTING PERSON                           0
WITH                                  ------------------------------------------

                                      8.  Shared Voting Power

                                                12,838,680
                                      ------------------------------------------

                                       3


                                      9.  Sole Dispositive Power

                                                0
                                      ------------------------------------------

                                      10.  Shared Dispositive Power

                                                12,838,680
                                      ------------------------------------------

11. Aggregate Amount Beneficially Owned by Each Reporting Person

                                                12,838,680
--------------------------------------------------------------------------------

12. Check Box if the Aggregate Amount in Row (11) Excludes Certain Shares

                                                                           [   ]

13. Percent of Class Represented by Amount in Row (11)

                                     53.96%
--------------------------------------------------------------------------------

14.  Type of Reporting Person

                                       HC
--------------------------------------------------------------------------------


1. Names of  Reporting  Persons,  I.R.S.  Identification  Nos. of above  persons
(entities only).

Principal Life Insurance Company
--------------------------------------------------------------------------------

2. Check the Appropriate Box if a Member of a Group (See Instructions)

(a)  [ X  ]

(b)  [    ]

3. SEC Use Only

--------------------------------------------------------------------------------

4.  Source of Funds

                                       00
--------------------------------------------------------------------------------

5. Check Box if Disclosure of Legal  Proceedings  is Required  Pursuant to items
2(d) or 2(e)
                                                                           [   ]



                                       4


6.  Citizenship or Place of Organization

                                      Iowa
--------------------------------------------------------------------------------

NUMBER OF SHARES                      7.  Sole Voting Power
BENEFICIALLY OWNED BY
EACH REPORTING PERSON
WITH
                                      ------------------------------------------

                                      8.  Shared Voting Power

                                                12,838,680
                                      ------------------------------------------

                                      9.  Sole Dispositive Power

                                      ------------------------------------------

                                      10.  Shared Dispositive Power

                                                12,838,680
                                      ------------------------------------------

11. Aggregate Amount Beneficially Owned by Each Reporting Person

                                   12,838,680
--------------------------------------------------------------------------------

12. Check Box if the Aggregate Amount in Row (11) Excludes Certain Shares
                                                                           [   ]

13. Percent of Class Represented by Amount in Row (11)

                                     53.96%
--------------------------------------------------------------------------------

14.  Type of Reporting Person

                                       IC
--------------------------------------------------------------------------------

ITEM 1.  SECURITY AND ISSUER.

This  statement  relates  to shares  of Series D  Preferred  Stock,  each  share
immediately  convertible  into 120 shares of Common Stock,  $.001 par value,  of
Patient  Infosystems,  Inc.,  whose  principal  offices are located at 46 Prince
Street, Rochester, NY 14607.

ITEM 2.  IDENTITY AND BACKGROUND.

This statement is being filed by: (i) Principal  Financial Group,  Inc. ("PFG"),
(ii) Principal  Financial  Services,  Inc.  ("PFS") and Principal Life Insurance
Company ("PLIC").

                                       5


PFG is a corporation  incorporated under the laws of the State of Delaware.  Its
common stock is publicly  traded on the New York Stock Exchange under the ticker
symbol PFG. PFG is a holding company.  The address of its principal business and
principal office is 711 High Street, Des Moines, Iowa 50392.

PFS, an Iowa  corporation,  is a  wholly-owned  subsidiary  of PFG and a holding
company.  Its  principal  business and  principal  office is located at 711 High
Street, Des Moines, Iowa 50392.

PLIC, a wholly-owned  subsidiary of PFS, is a stock insurance  company organized
under the laws of the State of Iowa. The principal  business activity of PLIC is
the provision of products and services for  businesses,  groups and  individuals
including individual insurance,  pension plans and group/employee  benefits. The
address of its principal  business and principal office is 711 High Street,  Des
Moines, Iowa 50392.

By virtue of their  ownership and control of PLIC, PFG and PFS have the ultimate
voting and dispositive  power with respect to the shares of Patient  Infosystems
Series D  Preferred  Stock  held by PLIC and may be deemed  indirect  beneficial
owners of all the shares of Patient  Infosystems  Series D Preferred Stock owned
by PLIC within the meaning of Rule 13d-3(a) under the Securities Exchange Act of
1934, as amended (the "Act").

Each of PFG, PFS and PLIC is hereafter  referred to individually as a "Reporting
Person" and  collectively  as  "Reporting  Persons."  As  discussed  below,  the
Reporting Persons  collectively may be deemed to be a group,  within the meaning
of Rule  13d-5(b)(1)  under  the Act,  beneficially  owning,  in the  aggregate,
106,989  shares of Patient  Infosystems  Series D Preferred  Stock  which,  upon
conversion to Patient  Infosystems Common Stock,  would represent  approximately
53.96% of the outstanding shares of Patient  Infosystems Common Stock within the
meaning of Rule 13d-3(a) and (d) of the Act.

Attached as Exhibit B hereto and  incorporated by reference  herein is a list of
all Directors and Executive Officers of each Reporting Person. The Directors and
Executive  Officers of the  Reporting  Persons can be contacted at the principle
business address provided above.

To the  knowledge of the Reporting  Persons,  none of the Directors or Executive
Officers of the Reporting  Persons has had any transactions in shares of Patient
Infosystems Series D Preferred Stock during the past 60 days, and no Director or
Executive Officer is a beneficial owner of shares of Patient  Infosystems Series
D Preferred Stock.

All of the Directors and Executive  Officers of the Reporting Persons are United
States  citizens,  except Victor H.  Loewenstein and Elizabeth E. Tallett,  both
directors of PFG, PFS and PLIC, who are citizens of the United Kingdom.

During the last five years, none of the Reporting  Persons,  or the Directors or
Executive  Officers of the Reporting  Persons,  has been convicted in a criminal
proceeding (excluding traffic violations or similar misdemeanors).

During the last five years, none of the Reporting  Persons,  or the Directors or
Executive  Officers  of the  Reporting  Persons,  has  been a  party  of a civil


                                       6


proceeding of a judicial or administrative body of competent jurisdiction and as
a result of such  proceeding  was or is subject to a  judgment,  decree or final
order  enjoining  future  violations of, or prohibiting or mandating  activities
subject  to,  or  finding  any  violation  with  respect  to,  federal  or state
securities law.

ITEM 3.  SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION.

The shares were paid for by using working capital of the Reporting Person.

ITEM 4.  PURPOSE OF TRANSACTION.

The  Reporting  Person  intends  to hold the  shares  for  long-term  investment
purposes.

PLIC entered into a Note and Stock Purchase  Agreement with Patient  Infosystems
pursuant to which PLIC purchased a Note in the amount of $1.5 million as well as
the 106,989 shares of Series D Preferred Stock reported herein.  Pursuant to the
Note and Stock Purchase Agreement,  PLIC will have the right to convert the Note
into Series D Preferred  Stock upon a  consummation  of a private  placement  of
Series D Preferred  Stock.  Patient  Infosystems  must amend its  Certificate of
Incorporation  to  increase  its  authorized  Common  Stock  to  allow  for  any
subsequent conversion of Series D Preferred Stock into Common Stock.

PLIC has also entered into a Creditor  Agreement with all parties except Patient
Infosystems to the Note and Stock Purchase  Agreement.  Pursuant to the Creditor
Agreement,  PLIC will  convert its Note into  Series D Preferred  Stock upon the
closing of an asset purchase agreement between Patient  Infosystems and American
CareSource Corporation.

Other than as set forth above,  the  Reporting  Persons do not have any plans or
proposals which relate to or would result in any of the  transactions  described
in  subparagraphs  (a) through (j) of Item 4 of Schedule  13D under the Act. The
Reporting Persons reserve the right to acquire additional  securities of Patient
Infosystems,  to dispose of securities of Patient  Infosystems at any time or to
formulate other purposes,  plans or proposals  regarding Patient  Infosystems or
any of  its  securities  to the  extent  deemed  advisable  in  light  of  their
respective general  investment and trading policies,  market conditions or other
factors.

ITEM 5.  INTEREST IN SECURITIES OF THE ISSUER.

          (a)  Beneficial Ownership

               The Reporting Persons are the beneficial owners of 106,989 shares
               of  Series  D  Preferred   Stock  each  such  share   immediately
               convertible  into 120  shares of Common  Stock.  Based on Patient
               Infosystems'   most  recent  public   filings,   this  represents
               beneficial ownership of 53.96% of the Patient Infosystems' Common
               Stock.

          (b) Voting and Dispositive Powers

               The  Reporting  Persons share voting and  dispositive  power with
               respect to the shares of Series D  Preferred  Stock  beneficially
               owned by them. 7

                                       7



          (c)  Transactions  in Securities of the Company  During the Past Sixty
               Days.

               Other than as set forth herein,  the  Reporting  Persons have not
               made any purchase or sales of securities  of Patient  Infosystems
               during the sixty (60) days  preceding  the date of this  Schedule
               13D.

          (d)  Dividends and Proceeds

               Other than the Reporting Persons,  no person is known to have the
               right to  receive  or the  power to  direct  the  receipt  of the
               dividends  from,  or the proceeds  from the sale of, the Series D
               Preferred Stock beneficially owned by the Reporting Persons.

          (e)  Date Reporting  Person Ceased to be Beneficial Owner of More than
               5% of the Company's Stock.

                                       N/A

ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT TO
SECURITIES OF THE ISSUER.

The  responses  to  Items 2 and 4 are  incorporated  herein  by  reference.  The
agreements referenced in Item 4 are attached hereto as Exhibits C and D.

Other  than the  above  mentioned  agreements,  there  are no  other  contracts,
arrangements,   understandings   or   relationships   with  respect  to  Patient
Infosystems  securities to which any Reporting Person is a party or by which any
Reporting Person is bound.

ITEM 7.  MATERIAL TO BE FILED AS EXHIBITS.

Exhibit A - Joint Filing Agreement
Exhibit B - Directors and Executive Officers
Exhibit C - Form of Note and Stock Purchase Agreement
Exhibit D - Form of Creditor Agreement


                                       8




                                   SIGNATURES

After reasonable inquiry and to the best of the Reporting Person's knowledge and
belief,  the Reporting  Person  certifies that the information set forth in this
statement is true, complete and correct.

April 21, 2003

PRINCIPAL FINANCIAL GROUP, INC.

By:  /S/ JOYCE N. HOFFMAN
     --------------------
     Joyce N. Hoffman
     Senior Vice President & Corporate Secretary


April 21, 2003

PRINCIPAL FINANCIAL SERVICES, INC.

By:  /S/ JOYCE N. HOFFMAN
     --------------------
     Joyce N. Hoffman
     Senior Vice President & Corporate Secretary


April 21, 2003

PRINCIPAL LIFE INSURANCE COMPANY

By:  /S/ JOYCE N. HOFFMAN
     --------------------
     Joyce N. Hoffman
     Senior Vice President & Corporate Secretary


                                       9



                                    EXHIBIT A

                             JOINT FILING AGREEMENT

         In accordance  with Rule 13d-1(k) under the Securities  Exchange Act of
1934, as amended,  each of the parties hereto agrees with the other parties that
the  statement  of Schedule  13D  pertaining  to certain  securities  of Patient
Infosystems,  Inc.  to which  this  agreement  is an  exhibit is filed by and on
behalf of each such party and that any amendment thereto will be filed on behalf
of each such party.

Dated:   April 21, 2003
                                               PRINCIPAL FINANCIAL GROUP,
                                               INC.

                                               By:    /S/ JOYCE N. HOFFMAN
                                                      ---------------------
                                                      Joyce N. Hoffman
                                                      Senior Vice President &
                                                      Corporate Secretary

                                               PRINCIPAL FINANCIAL
                                               SERVICES, INC.

                                               By:    /S/ JOYCE N. HOFFMAN
                                                      ---------------------
                                                      Joyce N. Hoffman
                                                      Senior Vice President &
                                                      Corporate Secretary


                                               PRINCIPAL LIFE INSURANCE
                                               COMPANY

                                               By:    /S/ JOYCE N. HOFFMAN
                                                      ---------------------
                                                      Joyce N. Hoffman
                                                      Senior Vice President &
                                                      Corporate Secretary


                                       10



                                    EXHIBIT B

                        DIRECTORS AND EXECUTIVE OFFICERS

PRINCIPAL FINANCIAL GROUP, INC.

DIRECTORS
                  B. J. (Betsy) Bernard
                  J. (Jocelyn)  Carter-Miller
                  G. E. (Gary)Costley
                  D. J.  (Dave)  Drury
                  D.  (Dan)  Gelatt
                  J. B.  (Barry)Griswell
                  S. L.  (Sandy)  Helton
                  C. S.  (Chuck)  Johnson
                  W. T.  (Bill) Kerr
                  R. L. (Dick) Keyser
                  V. H. (Victor)  Loewenstein
                  F. F. (Federico) Pena
                  D. M. (Don) Stewart
                  E. E. (Liz) Tallett

EXECUTIVE OFFICERS
                  J.  B.  (Barry)  Griswell,   Chairman,   President  and  Chief
                  Executive Officer
                  J. E. (John)  Aschenbrenner,  Executive Vice President
                  M. T. (Mike) Daley,  Executive  Vice President
                  M. H. (Mike) Gersie,  Executive  Vice President and Chief
                  Financial Officer
                  J. P. (Jim) McCaughan,  Executive Vice President
                  L. D. (Larry)  Zimpleman,  Executive  Vice  President
                  E. Z. (Ellen)  Lamale,  Senior Vice  President and Chief
                  Actuary
                  M. A. (Mary) O'Keefe,  Senior Vice  President
                  K. E. (Karen)  Shaff,  Senior Vice  President  and General
                  Counsel
                  G. P. (Gary)  Scholten, Senior  Vice  President  and Chief
                  Information  Officer
                  N. R. (Norman) Sorensen, Senior Vice President

PRINCIPAL FINANCIAL SERVICES, INC.

DIRECTORS
                  B. J. (Betsy) Bernard
                  J. (Jocelyn)  Carter-Miller
                  G. E. (Gary)Costley
                  D. J.  (Dave)  Drury
                  D.  (Dan)  Gelatt

                                       11


                  J. B.  (Barry)Griswell
                  S. L.  (Sandy)  Helton
                  C. S.  (Chuck)  Johnson
                  W. T.  (Bill) Kerr
                  R. L. (Dick) Keyser
                  V. H. (Victor)  Loewenstein
                  F. F. (Federico) Pena
                  D. M. (Don) Stewart
                  E. E. (Liz) Tallett

EXECUTIVE OFFICERS
                  J.  B.  (Barry)  Griswell, Chairman, President  and  Chief
                  Executive Officer
                  J. E. (John)  Aschenbrenner, Executive Vice President
                  M. T. (Mike) Daley, Executive Vice President
                  M. H. (Mike) Gersie, Executive Vice President and Chief
                  Financial Officer
                  J. P. (Jim) McCaughan, Executive Vice President
                  L. D. (Larry) Zimpleman, Executive Vice President
                  E. Z. (Ellen) Lamale, Senior Vice President and Chief Actuary
                  J. M. (Julia) Lawler, Senior Vice President and Chief
                  Investment Officer
                  M. A. (Mary) O'Keefe, Senior Vice President
                  K. E. (Karen) Shaff, Senior Vice President and General Counsel
                  G. P. (Gary)Scholten, Senior Vice President and Chief
                  Information Officer
                  N. R. (Norman) Sorensen, Senior Vice President

PRINCIPAL LIFE INSURANCE COMPANY

DIRECTORS
                  B. J. (Betsy) Bernard
                  J. (Jocelyn) Carter-Miller
                  G. E. (Gary) Costley
                  D. J. (Dave) Drury
                  D.  (Dan) Gelatt
                  J. B. (Barry) Griswell
                  S. L. (Sandy) Helton
                  C. S. (Chuck) Johnson
                  W. T. (Bill) Kerr
                  R. L. (Dick) Keyser
                  V. H. (Victor) Loewenstein
                  F. F. (Federico) Pena
                  D. M. (Don) Stewart
                  E. E. (Liz) Tallett

EXECUTIVE OFFICERS
                  J. B. (Barry) Griswell, Chairman, President and Chief
                  Executive Officer
                  J. E. (John) Aschenbrenner, Executive Vice President
                  M. T. (Mike) Daley, Executive Vice President

                                       12


                  M. H. (Mike) Gersie, Executive Vice President and Chief
                  Financial Officer
                  J. P. (Jim) McCaughan, Executive Vice President
                  L. D. (Larry) Zimpleman, Executive Vice President
                  P. F. (Paul) Bognanno, Senior Vice President
                  G. M. (Gary) Cain, Senior Vice President
                  C. R. (Bob) Duncan, Senior Vice  President
                  R. C. (Ralph) Eucher, Senior Vice President
                  T. J. (Tom) Graf, Senior Vice  President
                  J. N. (Joyce) Hoffman, Senior Vice President and  Corporate
                  Secretary
                  D. J. (Dan) Houston, Senior Vice President
                  E. Z. (Ellen) Lamale, Senior Vice President and Chief Actuary
                  J. M. (Julia) Lawler, Senior Vice President and Chief
                  Investment  Officer
                  M. A. (Mary) O'Keefe, Senior Vice President
                  G. P. (Gary) Scholten, Senior Vice President and Chief
                  Information  Officer
                  K. E. (Karen) Shaff, Senior Vice President and General Counsel
                  R. A. (Bob) Slepicka, Senior Vice President
                  N. R. (Norman) Sorensen, Senior Vice President



                                       13



                                    EXHIBIT C

                        NOTE AND STOCK PURCHASE AGREEMENT


THIS NOTE AND STOCK  PURCHASE  AGREEMENT  dated as of April 10, 2003,  is by and
among Patient  Infosystems,  Inc. (the "Issuer") and those  investors  listed on
SCHEDULE A hereto (each sometimes  referred to as a "Holder" and collectively as
the "Holders").

                                    RECITALS
A. The Issuer has requested that the Holders purchase certain notes and stock of
Issuer on the terms and conditions set forth herein.

B. The Holders  have  agreed to  purchase  such notes and stock on the terms and
conditions set forth therein.
                  ACCORDINGLY, the parties hereto hereby agree as follows:


DEFINITIONS

"Amendment" has the meaning set forth in Section 2.02(c).

"Additional Investor" has the meaning set forth in Section 2.01(d).

"Asset Purchase  Agreement" means the Asset Purchase  Agreement by and among the
Issuer, American CareSource Corporation,  certain stockholders of the Issuer and
certain  stockholders of American  CareSource  Corporation dated as of September
23, 2002, as further amended on April 10, 2003.

"Certificate of Designations" has the meaning set forth in Section 2.01(b).

"Collateral" has the meaning set forth in Section 2.02.

"Collateral Agent" has the meaning set forth in ARTICLE VI.

"Commitments" has the meaning set forth in Section 3.15.

"Closing  Date"  means  the date on which  all of the  conditions  set  forth in
ARTICLE V shall first have been satisfied.

"Common Stock" means the Common Stock, par value $.01 per share of the Issuer.

"Contractual  Obligation"  means any  provision  of any  security  issued by the
Issuer or of any agreement,  instrument or other undertaking to which the Issuer
is a party or by which it or any of its property is bound.

                                       14


"Event of Default" has the meaning set forth in ARTICILE VII.
         "Governmental Authority" means any nation,  government,  state or other
political subdivision thereof and any entity exercising executive,  legislative,
judicial,   regulatory  or  administrative   functions  of,  or  pertaining  to,
government.

"Lien"  means  any  mortgage,   pledge,   hypothecation,   assignment,   deposit
arrangement,  encumbrance, lien (statutory or other), or preference, priority or
other  security  agreement  or  preferential  arrangement  of any kind or nature
whatsoever.

"Lien  Subordination  Agreement" means the Lien  Subordination  Agreement by and
among the Holders,  Equity  Dynamics,  Inc.,  Wells Fargo Bank Iowa,  N.A., John
Pappajohn,  Derace Schaffer, the Issuer and any Additional Investor of even date
herewith.

"Material  Adverse Effect" means a material  adverse effect on (i) the business,
operations,  property,  condition  (financial  or otherwise) or prospects of the
Issuer,  (ii) the  ability of the Issuer to perform  its  obligations  under the
Purchase  Documents,  or (iii) the  validity or  enforceability  of the Purchase
Documents or the rights or remedies of the Holders hereunder or thereunder.

"Meeting" has the meaning set forth in Section 2.01(c).

"Notes" means the notes issued under this Purchase Agreement.

"Person" means an individual,  partnership,  corporation,  business trust, joint
stock company,  limited liability company,  trust,  unincorporated  association,
joint venture, Governmental Authority or other entity of whatever nature.

"Proxy Statement" has the meaning set forth in Section 2.01(c).

"Purchase Agreement" means this agreement as modified from time to time.

"Purchase Documents" means the documents listed in Section 0.

"Required Holders" means Holders holding Notes with 50% or more of the aggregate
principal amounts then outstanding under all the Notes.

"Required Shareholder Approval" has the meaning set forth in Section 2.01(c).

"Requirements of Laws" means as to any Person,  the  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  or binding  upon such Person or any of its property or to
which such Person or any of its material property is subject.

"Responsible  Officer"  means  the  chief  executive  officer,  president,  vice
president or chief financial officer of the Issuer.

"SEC" means the Securities and Exchange Commission.

                                       15


"Segregated  Bank Account" means an insured money market  account  maintained by
Issuer at Citbank,  account number 226045172, the proceeds of which shall be the
funds  loaned to Issuer by the  Holders  under the  Purchase  Agreement  and any
proceeds collected by the Issuer from American CareSource  Corporation under the
Credit Agreement by and between the Issuer and American  CareSource  Corporation
of even date herewith.

"Securities Act" means the Securities Act of 1933, as amended.

"Security  Agreement" means the Security Agreement by and between the Issuer and
the Holders of even date herewith.

"Series D Preferred  Stock" means Series D 9% Cumulative  Convertible  Preferred
Stock, par value $0.01 per share of the Issuer.

"Stock" means shares of Series D Convertible  Preferred  Stock,  par value $0.01
per share of the Issuer issued under this Purchase Agreement.

"Warrant"  shall mean the  Warrant  to  purchase  shares of Common  Stock of ACS
granted to Issuer by ACS on April 10, 2003.

PURCHASE OF CONVERTIBLE NOTES AND STOCK

SALE AND PURCHASE OF NOTES AND STOCK.

     SUBJECT TO THE TERMS AND CONDITIONS HEREOF AND FOR THE CONSIDERATION AND IN
     THE AMOUNTS  LISTED ON SCHEDULE 0, THE ISSUER AGREES TO ISSUE AND SELL, AND
     EACH HOLDER HEREBY AGREES, SEVERALLY AND NOT JOINTLY, TO PURCHASE THE NOTES
     AND THE STOCK AS SET FORTH ON  SCHEDULE  2.01.  ALL  PROCEEDS  RECEIVED  BY
     ISSUER FROM HOLDERS SHALL BE DEPOSITED IN THE  SEGREGATED  BANK ACCOUNT AND
     WILL  ONLY BE USED BY  ISSUER  TO FUND  THE  LOANS TO  AMERICAN  CARESOURCE
     CORPORATION  DESCRIBED IN SECTION 2.02, SUBJECT TO THE EXCEPTIONS SET FORTH
     IN SECTION  2.07  HEREOF..  THE NOTES  SHALL BE  SUBSTANTIALLY  IN THE FORM
     ANNEXED HERETO AS EXHIBIT 2.01(A).

     PRIOR TO THE CLOSING  DATE,  THE ISSUER SHALL HAVE FILED A  CERTIFICATE  OF
     DESIGNATION, POWERS, PREFERENCES AND RELATIVE, PARTICIPATING,  OPTIONAL AND
     OTHER SPECIAL RIGHTS AND THE  QUALIFICATIONS,  LIMITATIONS OR  RESTRICTIONS
     THEREOF OF THE SERIES D PREFERRED STOCK OF PATIENT  INFOSYSTEMS,  INC. (THE
     "CERTIFICATE OF DESIGNATION") SETTING FORTH, AMONG OTHER THINGS, THE TERMS,
     DESIGNATIONS,  POWERS, PREFERENCES, AND RELATIVE, PARTICIPATING,  OPTIONAL,
     AND  OTHER  SPECIAL  RIGHTS,  AND  THE   QUALIFICATIONS,   LIMITATIONS  AND
     RESTRICTIONS  OF THE SERIES D PREFERRED  STOCK, IN THE FORM ATTACHED HERETO
     AS EXHIBIT  2.01(B).  THE SERIES D PREFERRED STOCK SHALL HAVE THE TERMS SET
     FORTH IN THE CERTIFICATE OF DESIGNATION.

     THE ISSUER SHALL SUBMIT TO THE  STOCKHOLDERS  OF THE ISSUER FOR APPROVAL AT
     EITHER ITS NEXT ANNUAL MEETING OF  SHAREHOLDERS  OR A SPECIAL  MEETING (THE
     "MEETING") TO BE CALLED AND HELD AS PROMPTLY AS PRACTICABLE  AFTER THE DATE
     HEREOF,   AMONG  OTHER  THINGS,   AN  AMENDMENT  OF  ITS   CERTIFICATE   OF
     INCORPORATION  IN  ORDER  TO  INCREASE  ITS  AUTHORIZED   COMMON  STOCK  TO
     80,000,000 SHARES,  NECESSARY TO ALLOW FOR THE ISSUANCE OF THE COMMON STOCK


                                       16


     UPON  CONVERSION OF THE STOCK (THE  "AMENDMENT").  IN CONNECTION  WITH SUCH
     MEETING, THE ISSUER SHALL PREPARE AND FILE WITH THE SEC A PRELIMINARY PROXY
     STATEMENT (THE "PROXY  STATEMENT") BY WHICH THE ISSUER'S  SHAREHOLDERS WILL
     BE ASKED TO  APPROVE  THE  AMENDMENT  REFERRED  TO  HEREIN  (THE  "REQUIRED
     SHAREHOLDER APPROVAL"). THE ISSUER SHALL USE ITS BEST EFFORTS TO RESPOND TO
     ANY COMMENTS OF THE SEC,  AND TO CAUSE THE PROXY  STATEMENT TO BE MAILED TO
     THE ISSUER'S SHAREHOLDERS AT THE EARLIEST PRACTICABLE TIME. THE ISSUER WILL
     NOTIFY HOLDERS  PROMPTLY OF THE RECEIPT OF ANY COMMENTS FROM THE SEC OR ITS
     STAFF AND OF ANY  REQUEST  BY THE SEC OR ITS STAFF OR ANY OTHER  GOVERNMENT
     OFFICIALS  FOR  AMENDMENTS  OR  SUPPLEMENTS  TO THE PROXY  STATEMENT OR FOR
     ADDITIONAL   INFORMATION  AND  WILL  SUPPLY  HOLDERS  WITH  COPIES  OF  ALL
     CORRESPONDENCE BETWEEN THE ISSUER OR ANY OF ITS REPRESENTATIVES, ON THE ONE
     HAND, AND THE SEC, OR ITS STAFF OR ANY OTHER GOVERNMENT  OFFICIALS,  ON THE
     OTHER HAND, WITH RESPECT TO THE PROXY STATEMENT.  THE PROXY STATEMENT SHALL
     COMPLY IN ALL MATERIAL  RESPECTS WITH ALL APPLICABLE  REQUIREMENTS  OF LAW.
     HOLDERS  SHALL  PROVIDE  THE  ISSUER  WITH ALL  INFORMATION  ABOUT  HOLDERS
     REQUIRED TO BE INCLUDED OR INCORPORATED BY REFERENCE IN THE PROXY STATEMENT
     AND  SHALL  OTHERWISE  COOPERATE  WITH THE  ISSUER IN  TAKING  THE  ACTIONS
     DESCRIBED IN THIS PARAGRAPH. WHENEVER ANY EVENT OCCURS WHICH IS REQUIRED TO
     BE SET FORTH IN AN  AMENDMENT OR  SUPPLEMENT  TO THE PROXY  STATEMENT,  THE
     ISSUER OR  HOLDERS,  AS THE CASE MAY BE,  SHALL  PROMPTLY  INFORM THE OTHER
     PARTY OF SUCH  OCCURRENCE AND COOPERATE IN FILING WITH THE SEC OR ITS STAFF
     OR ANY OTHER  GOVERNMENT  OFFICIALS,  AND/OR MAILING TO SHAREHOLDERS OF THE
     ISSUER, SUCH AMENDMENT OR SUPPLEMENT. THE PROXY STATEMENT SHALL INCLUDE THE
     RECOMMENDATION   OF  THE  BOARD  OF   DIRECTORS  OF  THE  ISSUER  THAT  THE
     SHAREHOLDERS  OF THE ISSUER VOTE IN FAVOR OF AND  APPROVE  THE  AMENDMENTS;
     PROVIDED,  HOWEVER,  THAT THE BOARD OF DIRECTORS MAY WITHDRAW OR MODIFY ITS
     RECOMMENDATION  IN A MANNER  ADVERSE TO THE HOLDERS  ONLY IN THE EVENT THAT
     THE BOARD OF DIRECTORS  DETERMINES IN GOOD FAITH,  AFTER  CONSULTATION WITH
     AND AFTER  CONSIDERING  THE  ADVICE OF  OUTSIDE  COUNSEL,  THAT IN ORDER TO
     COMPLY WITH ITS FIDUCIARY  DUTIES TO STOCKHOLDERS  UNDER APPLICABLE LAW, IT
     IS  NECESSARY  FOR THE BOARD OF  DIRECTORS  TO SO  WITHDRAW  OR MODIFY  ITS
     RECOMMENDATION.
         (d) The Issuer and the Holders agree that this Purchase Agreement shall
         be amended to provide for the issuance of  additional  notes and shares
         of Series D Preferred  Stock to  additional  investors as  contemplated
         hereby under the terms and conditions of this Purchase  Agreement up to
         the maximum  amount set forth in SCHEDULE 2.01 and,  without  obtaining
         the  signature,  consent  or  permission  of any of the  Holders,  such
         additional  investors  shall become parties to this Purchase  Agreement
         and  the  other  Purchase   Documents  (as   applicable)  by  executing
         counterpart  signature  pages to such  agreements.  Upon and  after the
         closing of any such additional investments, the term "Stock" under this
         Purchase Agreement shall be deemed to include the shares so issued, the
         term  "Notes"  under  this  Purchase  Agreement  shall be  deemed to be
         include any notes issued for such  additional  investments and the term
         "Holder" shall include any such additional investor.

COLLATERAL SECURITY.

The  obligations  of the Issuer under this Purchase  Agreement and the Notes are
secured by a first priority  perfected  lien and security  interest in a note or


                                       17


series of notes issued to Issuer under the terms of the Credit  Agreement by and
between the Issuer and American  CareSource  Corporation  of even date herewith,
the proceeds thereof,  the Warrant issued to Issuer by ACS, all rights of Issuer
under the Credit Agreement and the related security agreement by and between the
Issuer and American CareSource  Corporation and the proceeds of the Notes issued
to  Issuer  by  Holders  as  maintained  in the  Segregated  Bank  Account  (the
"Collateral").

CONVERSION OF NOTES.

Each  Holder  shall have the right to convert  the Notes into Series D Preferred
Stock of the Issuer plus  accrued  but unpaid  interest at the rate equal to the
purchase price of such Series D Preferred Stock upon consummation of the private
placement of such Series D Preferred Stock as contemplated by the Asset Purchase
Agreement or at such other time as agreed upon by the parties.

SALE OF SECURITIES BY ISSUER.

The proceeds of any sale of stock,  debt or other  securities of the Issuer will
be applied towards repayment of the Notes on a pro rata basis among the Holders,
unless,  as to each  respective  Holder,  such  Holder  agrees to another use in
writing.

PREPAYMENT OF NOTES.

The Notes may be prepaid  in whole or in part,  on a pro rata basis at any time,
without  premium or penalty with respect to each Note,  with the written consent
of the Holders.

SEGREGATED BANK ACCOUNT.
         Issuer hereby  agrees to keep all proceeds from the Purchase  Agreement
and Notes in a Segregated Bank Account.


DISTRIBUTION OF FUNDS.
         Issuer hereby  agrees that  distribution  of funds from the  Segregated
Bank Account shall be made only to, or for the benefit of,  American  CareSource
Corporation.  Notwithstanding  the  foregoing,  (i) the  Issuer  may at any time
withdraw  $2,500 from the  Segregated  Bank Account  (such  amount  representing
Issuer's  funds used to open such  Segregated  Bank  Account),  (ii) all accrued
interest from funds deposited into the Segregated Bank Account shall be property
of the Issuer and shall be used by the Issuer at its sole  discretion  and (iii)
up to  $250,000  to be applied by the Issuer for  working  capital  purposes  of
Issuer.


LIMITATION ON LOANS WITH CITIBANK.

Issuer  shall  not enter  into any loan,  credit  agreement  or other  financing
arrangement  with  Citibank  as long as there are funds in the  Segregated  Bank
Account.

                                       18


REPRESENTATIONS AND WARRANTIES OF ISSUER

         To induce  the  Holders to enter into this  Purchase  Agreement  and to
purchase  the  Notes  and  Stock,   the  Issuer   hereby  makes  the   following
representations and warranties to the Holders.

ORGANIZATION, GOOD STANDING, POWER, ETC.

         The Issuer (a) is a corporation duly organized, validly existing and in
good standing under the laws of the State of Delaware, (b) is not required to be
qualified or  authorized  to do business as a foreign  corporation  in any other
jurisdiction  by reason of the  nature of the  business  conducted  by it or the
properties  owned  or  leased  or  operated  by it,  and (c)  has all  requisite
corporate power and authority,  licenses, permits and franchises to own or lease
and  operate  its  properties  and  carry on its  business  as  presently  being
conducted. The Issuer has no operating subsidiaries.

CERTIFICATE OF INCORPORATION AND BY-LAWS.

         The Issuer has  furnished  the Holders with a complete and correct copy
of (a) the Issuer's Certificate of Incorporation,  as amended to date, certified
by the  Secretary  of  State  of the  State of  Delaware,  and (b) the  Issuer's
By-Laws,  as amended to date,  certified  by the  Secretary  of the Issuer.  The
Issuer's  Certificate of Incorporation and By-Laws are in full force and effect,
and the Issuer is not in violation of any of the provisions thereof.

CAPITALIZATION.

                  THE  ISSUER'S  AUTHORIZED  CAPITALIZATION  IS AS  DISCLOSED ON
SCHEDULE  4.1.7(A) OF THE ASSET  PURCHASE  AGREEMENT.  THE STOCK WHEN ISSUED AND
DELIVERED  AS  HEREIN  PROVIDED,   WILL  BE  VALIDLY  ISSUED,   FULLY  PAID  AND
NON-ASSESSABLE.  THE ISSUER  AGREES  THAT,  SUBJECT TO  RECEIVING  THE  REQUIRED
SHAREHOLDER  APPROVAL, IT WILL AT ALL TIMES HAVE AUTHORIZED AND RESERVED FOR THE
PURPOSES OF  ISSUANCE,  UPON  EXERCISE OF THE  CONVERSION  RIGHTS OF THE STOCK A
SUFFICIENT  NUMBER OF SHARES OF ITS COMMON  STOCK TO PROVIDE FOR THE EXERCISE OF
ALL SUCH CONVERSION  RIGHTS.  ALL  OUTSTANDING  SHARES OF THE ISSUER ARE VALIDLY
ISSUED, FULLY PAID AND NON-ASSESSABLE.

AGREEMENTS RELATING TO CAPITAL STOCK.

         To the best knowledge of the Issuer,  other than as provided for in the
Asset Purchase  Agreement,  there are no agreements or  understandings  with any
person with respect to the voting of any shares of the Issuer's capital stock on
any matter  and the Issuer is not a party to any  agreement  which  imposes  any
obligation on the Issuer,  or creates any rights in any person,  with respect to
capital stock or any other securities of the Issuer.

OPTIONS, WARRANTS, RIGHTS, ETC.

         Other than as set forth in  SCHEDULE  3.05,  the  Issuer  does not have
outstanding  any  option,  warrant,  or other  right to  purchase or convert any
obligation into any of its capital stock.

                                       19


AUTHORIZATION OF AGREEMENT.

         The Issuer has the full  corporate  power and  authority  to enter into
this  Purchase  Agreement  and to  perform  its  obligations  hereunder  and the
execution,  delivery and  performance  of this Purchase  Agreement and all other
transactions  contemplated  hereby have been duly authorized by the Issuer. This
Purchase  Agreement  constitutes  a legal,  valid and binding  obligation of the
Issuer, enforceable in accordance with its terms, except as such enforcement may
be limited by bankruptcy, insolvency, moratorium or other similar enforcement of
creditors' rights generally.

EFFECT OF AGREEMENT, ETC.

         The execution,  delivery and performance of this Purchase  Agreement by
the Issuer, and consummation of the transactions  contemplated  hereby will not,
with or without the giving of notice and the lapse of time,  or both (a) violate
any  provision  of law,  statute,  rule or  regulation  to which  the  Issuer is
subject, (b) violate any judgment, order, writ or decree of any court applicable
to the  Issuer,  or (c)  result in the breach of, or  conflict  with,  any term,
covenant,  condition or provision of, result in the  modification or termination
of,  constitute a default under,  or result in the creation or imposition of any
lien,  security  interest,  charge or encumbrance upon, any of the properties or
assets of the Issuer  pursuant to any corporate  charter,  by-laws,  commitment,
contract or other agreement or instrument,  to which the Issuer is a party or by
which any of its assets or properties is or may be bound or affected.

GOVERNMENT AND OTHER CONSENTS.

         No  consent,  authorization  or  approval  of,  or  exemption  by,  any
governmental  or public body or  authority  is required in  connection  with the
execution, delivery and performance by the Issuer of this Purchase Agreement, or
to the taking by the Issuer of any action herein contemplated.

FINANCIAL STATEMENTS.

         The Issuer has delivered to the Holders the financial statements of the
Issuer as of and for the fiscal year ended  December  31,  2002,  including  the
Balance Sheet  ("Balance  Sheet"),  the related  statements of income,  retained
earnings and  stockholders'  equity for the fiscal year then ended (the "Balance
Sheet Date") audited by Deloitte & Touche,  LLP,  independent  certified  public
accountants,  including the related schedules and notes. The foregoing financial
statements  (the "Financial  Statements")  have been prepared in accordance with
generally accepted accounting  principles  consistently applied, are correct and
complete in all material  respects and fairly  present in all material  respects
the financial  position and results of operations of the Issuer as of said dates
and for the periods indicated.

ABSENCE OF UNDISCLOSED LIABILITIES.

         The  Financial  Statements  make full and  adequate  provision  for all
material obligations,  liabilities and commitments (fixed and contingent) of the
Issuer as of the dates  thereof  and the  Issuer  had no  material  obligations,
liabilities or commitments  (fixed or contingent)  which were required to be set


                                       20


forth or reserved in the  Financial  Statements  in  accordance  with  generally
accepted accounting principles which were not so set forth or reserved.

ABSENCE OF CERTAIN CHANGES OR EVENTS.

Except as set forth in SCHEDULE  3.11,  since the Balance Sheet Date, the Issuer
has not:
                                         -------------
          (a)  incurred any obligation or liability (fixed or contingent) except
               (i) trade or business obligations incurred in the ordinary course
               of  business,  none of  which  is  materially  adverse,  and (ii)
               obligations  and  liabilities  under the Commitments set forth in
               SCHEDULE 3.15,

          (b)  suffered any material adverse change in its financial  condition,
               results  of   operations,   properties,   business   or  business
               relationships;

          (c)  suffered the occurrence of any events which,  individually  or in
               the aggregate, have had, or might reasonably be expected to have,
               a material adverse effect on its financial condition,  results of
               operations, properties, business or business relationships;

          (d)  discharged  or satisfied any lien or  encumbrance  or incurred or
               paid any obligation or liability (fixed and  contingent),  except
               (i) current  obligations and  liabilities  fully reflected in the
               Balance Sheet, (ii) current obligations and liabilities  incurred
               since the Balance Sheet Date in the ordinary  course of business,
               and (iii)  obligations and  liabilities  incurred in carrying out
               the transactions contemplated by this Purchase Agreement;

          (e)  sold,  transferred  or leased any of its assets or  properties or
               entered into any transaction other than in the ordinary course of
               business;

          (f)  suffered any loss not in the ordinary course of business; or
          (g)  declared any dividend or made any payment or  distribution to its
               stockholders or purchased or redeemed any of its capital stock.

TAX MATTERS.

         The Issuer has prepared and filed with the  appropriate  United States,
state and local government  agencies,  all tax returns required to be filed; the
Issuer has paid all taxes  shown on such tax returns to be payable or which have
come due pursuant to any assessment, deficiency notice, 30-day letter or similar
notice received by it except for taxes  reflected in the Balance Sheet;  and the
provisions  for income taxes payable in the Balance Sheet are sufficient for all
accrued and unpaid  taxes,  whether or not  disputed  and for all periods to and
including the Balance Sheet Date. The Federal income tax liability of the Issuer
has not been  examined and reported on by the Internal  Revenue  Service for any
fiscal year(s).  The Issuer has not executed or filed with the Internal  Revenue
Service or any other taxing  authority  any  agreement  extending the period for


                                       21


assessment or collection of any income taxes or is a party to any pending action
or proceeding  by any  governmental  authority  for  assessment or collection of
taxes,  and no claims for  assessment  or  collection of taxes has been asserted
against the Issuer.

TITLE TO PROPERTIES; ABSENCE OF LIENS AND ENCUMBRANCES, ETC.

         Except  as  indicated  on  SCHEDULE  3.13,  the  Issuer  has  good  and
marketable  title to all of its  assets  (tangible  and  intangible)  (including
without  limitation the assets  reflected in the Balance Sheet,  except as since
sold or otherwise  disposed of, in the ordinary  course of  business),  free and
clear of all mortgages,  claims, liens, charges and encumbrances,  except (i) as
referred to in the Balance  Sheet or  disclosed in the notes  thereto,  (ii) the
lien of taxes  not yet due and  payable  or  being  contested  in good  faith by
appropriate proceedings,  (iii) such imperfections of title and encumbrances, if
any, which do not materially  detract from the value, or interfere with the use,
of the  properties  of the Issuer or  otherwise  materially  impair its business
operations.  The fixed assets of the Issuer referred to in the Balance Sheet are
all  located  on real  property  leased  by the  Issuer.  The  leases  and other
agreements or instruments under which the Issuer holds, leases or is entitled to
the use of any real or  personal  property  are in full force and effect and all
rentals,  royalties  or other  payments  accruing  thereunder  prior to the date
hereof have been duly paid.  The Issuer has not received  notice of violation of
any applicable law, ordinance,  regulation, order or requirement relating to its
operations, or its owned or leased properties.

CONDITION OF EQUIPMENT, ETC.

         The  equipment  owned,  operated,  or leased  by the  Issuer is in good
condition  and  repair  (ordinary  wear and tear which are not such as to affect
adversely the operation of its business  excepted) and suitable for the uses for
which intended.

AGREEMENTS, PLANS, ARRANGEMENTS, ETC.
                  Except  as set forth in  SCHEDULE  3.15,  the  Issuer is not a
party  to,  nor are the  Issuer  or any of its  properties  or  assets  bound or
affected by, any written or oral

          (a)  material  lease  agreement  (whether  as lessor or lessee) for an
               aggregate  amount of more than $25,000 per year  relating to real
               or personal property;

          (b)  license agreement, assignment or contract (whether as licensor or
               licensee,  assignor or assignee) for an aggregate  amount of more
               than  $25,000  per  year  relating  to  trademarks,   patents  or
               copyrights  (or  applications  therefor),  unpatented  designs or
               styles, trade secrets, proprietary software programs and systems,
               know-how  or  technical   assistance  including  agreements  with
               customers  of the Issuer  granting  licenses  to use  proprietary
               software  programs  and systems  other than third party  software
               licenses  agreed  to in  the  ordinary  course  of  the  Issuer's
               business;

          (c)  employment  agreement  not  terminable  without  liability to the
               employer upon notice to the employee of not more than 30 days, or


                                       22


               employment agreement providing  compensation of more than $25,000
               per year (including all salary,  bonuses and  commissions) to any
               employee;
          (d)  agreement,  other  than  any  customer  contract,  in  excess  of
               $100,000 for the purchase or sale of goods, materials,  supplies,
               services,  machinery or capital  assets;  (e) agreement  with any
               labor union;
          (f)  policy  of  insurance  (including  surety  bonds)  in force  with
               respect to such  corporation  or any of its  properties,  assets,
               executive officers, agents or employees;
          (g)  agreement   with  any   distributor,   dealer,   sales  agent  or
               representative;
          (h)  agreement guaranteeing, indemnifying or otherwise becoming liable
               for  the   obligations  or  liabilities  of  another  other  than
               obligations  or liabilities  for patent,  copyright and trademark
               infringement   arising  out  of  the  Issuer's   standard   sales
               agreements;
          (i)  agreement for borrowing or lending of money;
          (j)  agreement with any bank, finance company or similar  organization
               which acquires from such corporation  consumer paper or contracts
               for the sale of merchandise on credit;
          (k)  agreement  granting  any  person  a lien,  security  interest  or
               mortgage on any property or asset of such corporation, including,
               without limitation,  any factoring agreement or agreement for the
               assignment of accounts receivable;
          (l)  bonus,   deferred   compensation,    profit   sharing,   pension,
               retirement,  stock option, stock purchase,  insurance (other than
               medical  insurance for  employees) or other plan,  arrangement or
               practice providing employee or executive benefits;
          (m)  advertising  agreement with any  newspaper,  magazine or radio or
               television station;
          (n)  agreement which restricts it from doing business  anywhere in the
               world;
          (o)  agreements  with any  consultant  in an aggregate  amount of more
               than $50,000 per year; or
          (p)  other material  agreements  affecting the Issuer or its assets or
               business.

                                       23


Correct  and  complete  copies  of all  such  agreements,  plans,  policies  and
arrangements  and such other  instruments  referred to in the foregoing  Section
3.15(a)  through  (p) (or,  where  they are  oral,  true  and  complete  written
summaries thereof)  (collectively  referred to herein as the "Commitments") have
been made  available for  inspection  at the offices of the Issuer.  Each of the
Commitments is now valid, in full force and effect and enforceable in accordance
with its terms,  and the Issuer has  fulfilled,  or taken all action  reasonably
necessary  to enable it to fulfill  when due,  all of its  material  obligations
under the Commitments.  There has not occurred any default by the Issuer, or any
event  caused by the  Issuer or any of its  employees  or agents  which with the
lapse of time or the election of any person other than the Issuer, will become a
default,  nor to the  knowledge of the Issuer has there  occurred any default by
others or any event  which with the lapse of time or the  election of the Issuer
will become a default under any of the  Commitments,  except  defaults,  if any,
which  will not  result in any  material  loss to or  liability  of the  Issuer.
Neither the Issuer,  nor, to the knowledge of the Issuer, any other party, is in
arrears in respect of the performance or satisfaction of the terms or conditions
on its part to be  performed or satisfied  under any of the  Commitments  and no
wavier or indulgence has been granted by any of the parties thereto.

PATENTS, TRADEMARKS, COPYRIGHTS, PROPRIETARY SOFTWARE PRODUCTS.
                  (a) To the  knowledge  of  the  Issuer,  the  Issuer  owns  or
         possesses  adequate  licenses or other valid rights to use (without the
         making of any payment to others or the  obligation  to grant  rights to
         others in exchange) all patents, patent rights,  trademarks,  trademark
         rights,  trade  names,  trade  name  rights,  copy  rights,   know-how,
         proprietary   software  programs  and  other  proprietary   information
         necessary to the conduct of its business as presently being or proposed
         to be conducted; and

         (b) the validity of such items and the title thereto of the Issuer have
         not been  questioned in any  litigation to which the Issuer is a party,
         nor, to the knowledge of the Issuer, the conduct of the business of the
         Issuer as now operated  does not conflict  with valid  patents,  patent
         rights,  proprietary rights,  licenses,  trademarks,  trademark rights,
         trade  names,  trade  name  rights or  copyrights  of others in any way
         likely to affect adversely in any material manner the business,  assets
         or  condition,  financial  or  otherwise,  of the  Issuer.  No material
         infringement of any  proprietary  right owned or licensed by the Issuer
         is known to the Issuer. All patents,  patent applications and rights to
         inventions or proprietary software products heretofore owned or held by
         any officer or  shareholder  of the Issuer and relating to its business
         in any manner have been duly and effectively transferred to the Issuer.

PERMITS, LICENSES, ETC.

To the  knowledge  of the  Issuer,  the Issuer  does not  require  any  permits,
licenses,  orders and approvals of federal,  state,  local or  governmental  and
regulatory bodies in order to carry on its businesses as presently conducted.

                                       24


LITIGATION.

There is no claim,  action,  suit,  proceeding,  arbitration,  investigation  or
inquiry  pending  before  any  federal,  state,  municipal,  or  other  court or
governmental  or  administrative  body or  agency,  or any  private  arbitration
tribunal, or, to the knowledge of the Issuer, threatened against, relating to or
affecting  the Issuer or any of its assets or  properties,  or the  transactions
contemplated by this Purchase  Agreement;  nor to the knowledge of the Issuer is
there any basis  for any such  claim,  action,  suit,  proceeding,  arbitration,
investigation  or inquiry  which may have any material  adverse  effect upon the
assets,  properties or business of the Issuer, or the transactions  contemplated
by this Purchase  Agreement.  Neither the Issuer nor any officer,  director,  or
employee of the Issuer has been  permanently or  temporarily  enjoined by order,
judgment or decree of any court or other tribunal or any agency from engaging in
or continuing any conduct or practice in connection with the business engaged in
by the Issuer.  There is not in existence  any order,  judgment or decree of any
court or other tribunal or any agency  enjoining or requiring the Issuer to take
any  action of any kind or to which the  Issuer,  its  business,  properties  or
assets  are  subject or bound.  The  Issuer is not in  default  under any order,
license,  regulation  or  demand of any  federal,  state or  municipal  or other
governmental agency or with respect to any order, writ,  injunction or decree of
any court.

NO INTEREST IN COMPETITORS, ETC.

Neither the  Issuer,  nor any  affiliate  of any of the  foregoing,  directly or
indirectly,  owns  any  interest  in or  controls  or is an  employee,  officer,
director,  or partner of or  participant  in or consultant  to any  corporation,
partnership,  limited partnership,  joint venture,  association, or other entity
which is a competitor, supplier, customer, landlord or tenant of the Issuer.

LOANS WITH CITIBANK.

The Issuer has no loans, credit agreements or other financing  arrangements with
Citibank.

REPRESENTATIONS AND WARRANTIES OF HOLDERS

                  Each Holder hereby represents and warrants to the Issuer,  the
following facts and understandings:

OPPORTUNITY TO SPEAK TO ISSUER.
         Each  Holder   acknowledges  that  it  has  had  a  full  and  complete
opportunity  to make inquiries as to the Issuer's plan of operations and that it
fully understands the risks involved in the Issuer.


OPPORTUNITY TO SPEAK TO TAX ADVISOR.

Each Holder has been  advised by the Issuer to consult with his own personal tax
advisor to determine  the effect of an  investment in the Notes and Stock on his
Federal income tax status.

                                       25


OPPORTUNITY TO REVIEW ISSUER'S DOCUMENTS, RECORDS AND BOOKS.

All documents,  records and books  pertaining to this  investment have been made
available  for  inspection  by each  Holder  or, if  applicable,  each  Holder's
attorney  and/or  accountant;  and each  Holder  understands  that the books and
records of the Issuer will be available during reasonable  business hours at its
principal place of business.

RISK OF INVESTMENT.

Each Holder  understands  that operation of the Issuer's  business is subject to
numerous risks.  Each Holder is able to bear the economic risk of the investment
(i.e., he can afford a complete loss of his investment). Each Holder is familiar
with the nature of and risks  incident  to  investment  in  securities,  and has
determined  (either  alone or if need be on the basis of  consultation  with his
business  and tax  advisors)  that  the  purchase  of the  Notes  and  Stock  is
consistent with his investment objectives and income prospects.

SECURITIES ACQUIRED FOR INVESTMENT.

The Notes and shares of Stock  acquired  by each  Holder  will be  acquired  for
investment and not with a view to the resale or distribution of such securities;
and such  securities  are being  acquired by each Holder for his own account and
with his own  funds  and no  person,  other  than the  Holder,  has a direct  or
indirect beneficial interest in such securities. Each Holder further understands
that  holding  the  investment  for any  pre-defined  period  of time  does  not
constitute  holding for  investment or an agreement to hold the  securities  for
investment  and not with a view to  resale  or  distribution.  Each  Holder  has
adequate  means of  providing  for his current  needs and  foreseeable  personal
contingencies,  has no need for liquidity in this investment, and anticipates no
need now or in the  foreseeable  future to sell any of the  securities  which he
hereby purchases.

ACCREDITED INVESTOR.

Each Holder qualifies as one of the following:

                  (a) Any bank as defined in Section  3(a)(2) of the  Securities
Act or any  savings  and loan  association  or other  institution  as defined in
Section  3(a)(5)(A) of the  Securities  Act whether  acting in its individual or
fiduciary  capacity;  any broker or dealer registered  pursuant to Section 15 of
the Securities Exchange Act of 1934; any insurance company as defined in Section
2(13) of the  Securities  Act;  any  investment  company  registered  under  the
Investment Company Act of 1940 or a business  development  company as defined in
Section  2(a)(48)  of the  Investment  Company Act of 1940;  any Small  Business
Investment  Company  licensed by the U.S.  Small Business  Administration  under
Section  301(c) or (d) of the Small  Business  Investment  Act of 1958; any plan
established and maintained by a state, its political subdivisions, or any agency
or instrumentality of a state or its political subdivisions,  for the benefit of
its  employees,  if such plan has total  assets  in  excess of  $5,000,000;  any
employee benefit plan within the meaning of Title I of the Employment Retirement
Income Security Act of 1974 ("ERISA"),  if the investment  decision is made by a
plan fiduciary,  as defined in Section 3(21) of ERISA, which is either a bank, a
savings  and  loan  association,  insurance  company  or  registered  investment
advisor,  or if the  employee  benefit  plan  has  total  assets  in  excess  of


                                       26


$5,000,000,  or, if a self-directed plan, with investment  decisions made solely
by persons that are accredited investors;

                  (b) Any  private  business  development  company as defined in
Section 202(a)(22) of the Investment Advisors Act of 1940;

                  (c) Any  organization  described  in Section  501(c)(3) of the
Internal Revenue Code, corporation,  Massachusetts or similar business trust, or
partnership,  not formed for the specific  purpose of acquiring  the  securities
offered, with total assets in excess of $5,000,000;

                  (d) Any director or executive officer of the Issuer;

                  (e) Any natural person whose  individual  net worth,  or joint
net worth with that person's spouse, at the time of his or her purchase, exceeds
$1,000,000;

                  (f) Any natural person who had an individual  income in excess
of  $200,000  in each of the two most  recent  years or joint  income  with that
person's  spouse  in  excess  of  $300,000  in each  of  those  years  and has a
reasonable expectation of reaching the same income level in the current year;

                  (g) Any trust,  with total assets in excess of $5,000,000  not
formed for the  specific  purpose of acquiring  the  securities  offered,  whose
purchase is  directed  by a  sophisticated  person as  described  in Rule 506 of
Regulation D; or

                  (h)  Any  entity  in  which  all  of  the  equity  owners  are
accredited investors.

RESALE OF STOCK

Each Holder  understands that the Notes and Stock have not been registered under
the Securities Act, in reliance on an exemption for private  offerings.  Because
the Issuer has no obligation to effect such  registration,  each Holder may have
to continue to bear the economic risk of each  Holder's  investment in the Notes
and Stock for an  indefinite  period;  and each Holder will not be  permitted to
transfer  the  Notes or any  shares of Stock in the  absence  of an  opinion  of
counsel satisfactory to counsel for the Issuer that registration is not required
under the Securities Act or under  applicable state securities laws. Each Holder
understands  that this  offering of the Notes and Stock has not been  registered
with securities agencies of any State in which they are offered in reliance upon
exemptions from registration as a private  placement.  The offering of the Notes
and Stock has not been  approved  or  disapproved  by federal of state  security
authorities.

CONDITIONS

         The  effectiveness  of  this  Purchase  Agreement  is  subject  to  the
satisfaction  on or prior  to the  Closing  Date,  of the  following  conditions
precedent:

                                       27


PURCHASE DOCUMENTS.

The Holders shall have received the following  documents  executed and delivered
by a Responsible Officer of the Issuer:

     THIS PURCHASE AGREEMENT;

     THE NOTES;

     THE SECURITY AGREEMENT

     CERTIFICATES REPRESENTING THE STOCK;

     THE LIEN SUBORDINATION AGREEMENT; AND

     REGISTRATION RIGHTS AGREEMENT IN THE FORM ATTACHED AS EXHIBIT 5.01 HERETO.

LIEN IN FAVOR OF COLLATERAL AGENT.

The Collateral Agent shall have first priority  perfected  security interests in
the Collateral.

PROCEEDINGS AND CERTIFICATES.

The Holders shall have received a copy of the resolutions, in form and substance
satisfactory  to  the  Holders,  of  the  Boards  of  Directors  of  the  Issuer
authorizing  (i) the  execution,  delivery  and  performance  of  this  Purchase
Agreement,  the Notes and any other Purchase Document,  (ii) the issuance of the
Stock and (iii) the borrowings contemplated hereunder certified by the Secretary
of the Issuer as of the Closing  Date,  which  certificate  shall state that the
resolutions  thereby  certified  have not been  amended,  modified,  revoked  or
rescinded and shall be in form and substance satisfactory to the Holders.

AMENDMENT TO ASSET PURCHASE AGREEMENT

American CareSource  Corporation and the Issuer shall have executed an amendment
to the Asset Purchase Agreement including,  but not limited to, modifications of
the  provisions  regarding  (i) control of the Board of  Directors of the Issuer
after  closing,  (ii)  extension of the repayment of debt to Eric Brauss and his
affiliates,  (iii)  termination  of the Asset  Purchase  Agreement  based on the
filing  date of the  proxy  statement  of the  Issuer  with the  Securities  and
Exchange  Commission and (iv)  employment  agreements  with certain  officers of
American CareSource Corporation.

CERTIFICATE OF DESIGNATION

The Issuer shall have filed with the Secretary of State of the State of Delaware
the Certificate of Designations in the form attached as EXHIBIT 2.01(B).

                                       28


COLLATERAL AGENT

COLLATERAL AGENT

     EQUITY DYNAMICS,  INC. SHALL ACT AS COLLATERAL AGENT AS CONTEMPLATED HEREIN
     AND IN THE SECURITY AGREEMENT.

     THE REQUIRED  HOLDERS SHALL HAVE THE RIGHT TO DIRECT THE COLLATERAL  AGENT,
     FROM TIME TO TIME, TO CONSENT TO ANY AMENDMENT,  MODIFICATION OR SUPPLEMENT
     TO OR WAIVER OF ANY PROVISION OF THE SECURITY  AGREEMENT AND TO RELEASE ANY
     COLLATERAL FROM ANY LIEN OR SECURITY INTEREST HELD BY THE COLLATERAL AGENT;
     PROVIDED,  HOWEVER, THAT (I) NO SUCH DIRECTION SHALL REQUIRE THE COLLATERAL
     AGENT TO CONSENT TO THE  MODIFICATION  OF ANY PROVISION OR PORTION  THEREOF
     WHICH (IN THE SOLE JUDGMENT OF THE COLLATERAL AGENT) IS INTENDED TO BENEFIT
     THE COLLATERAL  AGENT,  (II) THE  COLLATERAL  AGENT SHALL HAVE THE RIGHT TO
     DECLINE  TO  FOLLOW  ANY  SUCH  DIRECTION  IF THE  COLLATERAL  AGENT  SHALL
     DETERMINE  IN GOOD FAITH THAT THE DIRECTED  ACTION IS NOT  PERMITTED BY THE
     TERMS OF THE SECURITY  AGREEMENT OR MAY NOT LAWFULLY BE TAKEN, AND (III) NO
     SUCH  DIRECTION  SHALL  WAIVE  OR  MODIFY  ANY  PROVISION  OF THE  SECURITY
     AGREEMENT THE WAIVER OR  MODIFICATION  OF WHICH REQUIRES THE CONSENT OF ALL
     HOLDERS. THE COLLATERAL AGENT MAY RELY ON ANY SUCH DIRECTION GIVEN TO IT BY
     THE REQUIRED HOLDERS AND SHALL BE FULLY PROTECTED IN RELYING  THEREON,  AND
     SHALL UNDER NO  CIRCUMSTANCES  BE LIABLE TO ANY HOLDER OR ANY OTHER  PERSON
     FOR  TAKING  OR  REFRAINING  FROM  TAKING  ACTION  IN  ACCORDANCE  WITH ANY
     DIRECTION OR OTHERWISE IN ACCORDANCE WITH THE SECURITY AGREEMENT.

DUTIES OF COLLATERAL AGENT

     THE  COLLATERAL  AGENT SHALL HAVE AND MAY  EXERCISE  SUCH POWERS  UNDER THE
     SECURITY AGREEMENT AS ARE SPECIFICALLY DELEGATED TO THE COLLATERAL AGENT BY
     THE TERMS HEREOF AND THEREOF,  TOGETHER WITH SUCH POWERS AS ARE  REASONABLY
     INCIDENTAL THERETO.  THE COLLATERAL AGENT SHALL NOT HAVE ANY IMPLIED DUTIES
     OR ANY OBLIGATIONS TO TAKE ANY ACTION UNDER THE SECURITY AGREEMENT.

     THE  COLLATERAL  AGENT SHALL BE  REQUIRED TO ACT OR TO REFRAIN  FROM ACTING
     (AND SHALL BE FULLY  PROTECTED IN SO ACTING OR REFRAINING FROM ACTING) UPON
     THE WRITTEN  INSTRUCTIONS,  AND THE  FURNISHING  OF A DEPOSIT IN ACCORDANCE
     WITH SECTION 0 HEREOF, OF THE REQUIRED HOLDERS AND SUCH INSTRUCTIONS  SHALL
     BE BINDING UPON ALL THE HOLDERS;  PROVIDED THAT THE COLLATERAL  AGENT SHALL
     NOT BE REQUIRED TO TAKE ANY ACTION WHICH THE COLLATERAL AGENT IN GOOD FAITH
     BELIEVES  (I)  COULD  REASONABLY  BE  EXPECTED  TO  EXPOSE  IT TO  PERSONAL
     LIABILITY OR (II) IS CONTRARY TO APPLICABLE LAW.

     ABSENT WRITTEN INSTRUCTIONS FROM REQUIRED HOLDERS TO THE CONTRARY AT A TIME
     WHEN AN EVENT  OF  DEFAULT  SHALL  HAVE  OCCURRED  AND BE  CONTINUING,  THE
     COLLATERAL  AGENT MAY TAKE,  BUT SHALL HAVE NO OBLIGATION TO TAKE,  ANY AND
     ALL ACTIONS  UNDER THE SECURITY  AGREEMENT OR OTHERWISE AS IT SHALL DEEM TO
     BE IN THE BEST INTERESTS OF THE HOLDERS.



                                       29


     THE RELATIONSHIP  BETWEEN THE COLLATERAL AGENT AND THE HOLDERS IS AND SHALL
     BE ONLY TO THE EXTENT  EXPLICITLY  PROVIDED  FOR  HEREIN  THAT OF AGENT AND
     PRINCIPAL AND NOTHING HEREIN  CONTAINED SHALL BE CONSTRUED TO IMPOSE ON THE
     COLLATERAL AGENT DUTIES AND OBLIGATIONS OTHER THAN THOSE EXPRESSLY PROVIDED
     FOR HEREIN.  WITHOUT LIMITING THE GENERALITY OF THE FOREGOING,  NEITHER THE
     COLLATERAL AGENT NOR ANY OF ITS EMPLOYEES, PARTNERS OR AGENTS SHALL

         BE  RESPONSIBLE  TO THE HOLDERS FOR ANY  RECITALS,  REPRESENTATIONS  OR
         WARRANTIES CONTAINED IN, OR FOR THE EXECUTION,  VALIDITY,  GENUINENESS,
         PERFECTION,  EFFECTIVENESS OR ENFORCEABILITY OF, THE SECURITY AGREEMENT
         (IT BEING EXPRESSLY  UNDERSTOOD THAT ANY DETERMINATION OF THE FOREGOING
         IS THE RESPONSIBILITY OF THE ISSUER),

         BE   RESPONSIBLE   TO  THE  HOLDERS  FOR  THE  VALIDITY,   GENUINENESS,
         PERFECTION,   EFFECTIVENESS,   ENFORCEABILITY,   EXISTENCE,   VALUE  OR
         ENFORCEMENT  OF ANY  SECURITY  INTEREST  IN THE  COLLATERAL  (IT  BEING
         EXPRESSLY  UNDERSTOOD  THAT ANY  DETERMINATION  OF THE FOREGOING IS THE
         RESPONSIBILITY OF EACH HOLDER),

         BE UNDER ANY DUTY TO  INQUIRE  INTO OR PASS  UPON ANY OF THE  FOREGOING
         MATTERS,  OR TO MAKE ANY  INQUIRY  CONCERNING  THE  PERFORMANCE  BY ANY
         PERSON OF ITS OR THEIR  OBLIGATIONS  UNDER THE SECURITY  AGREEMENT  (IT
         BEING EXPRESSLY  UNDERSTOOD THAT ANY  DETERMINATION OF THE FOREGOING IS
         THE RESPONSIBILITY OF THE ISSUER),

         BE DEEMED TO HAVE  KNOWLEDGE OF THE  OCCURRENCE OF AN EVENT OF DEFAULT,
         UNLESS IT SHALL HAVE  RECEIVED  WRITTEN  NOTICE  THEREOF  FROM EITHER A
         HOLDER OR THE ISSUER,

         BE RESPONSIBLE OR LIABLE FOR ANY SHORTAGE, DISCREPANCY, DAMAGE, LOSS OR
         DESTRUCTION  OF ANY  PART OF THE  COLLATERAL  WHEREVER  THE SAME MAY BE
         LOCATED  REGARDLESS OF THE CAUSE  THEREOF  UNLESS THE SAME SHALL HAPPEN
         SOLELY  THROUGH  THE GROSS  NEGLIGENCE  OR  WILLFUL  MISCONDUCT  OF THE
         COLLATERAL AGENT AS SHALL HAVE BEEN DETERMINED IN A FINAL NONAPPEALABLE
         JUDGMENT OF A COURT OF COMPETENT JURISDICTION,

         HAVE ANY  LIABILITY  FOR ANY ERROR OR  OMISSION OR ACTION OR FAILURE TO
         ACT OF ANY  KIND  MADE IN THE  SETTLEMENT,  COLLECTION  OR  PAYMENT  IN
         CONNECTION WITH THE SECURITY  AGREEMENT OR ANY OF THE COLLATERAL OR ANY
         INSTRUMENT  RECEIVED IN PAYMENT  THEREFOR  OR FOR ANY DAMAGE  RESULTING
         THEREFROM  OTHER THAN AS A SOLE RESULT OF ITS OWN GROSS  NEGLIGENCE  OR
         WILLFUL   MISCONDUCT   AS  SHALL  HAVE  BEEN   DETERMINED  IN  A  FINAL
         NONAPPEALABLE JUDGMENT OF A COURT OF COMPETENT JURISDICTION, AND

         IN ANY EVENT,  BE LIABLE AS SUCH FOR ANY ACTION TAKEN OR OMITTED BY IT,
         ABSENT, IN EACH CASE DESCRIBED IN THIS SECTION, ITS GROSS NEGLIGENCE OR
         WILLFUL   MISCONDUCT   AS  SHALL  HAVE  BEEN   DETERMINED  IN  A  FINAL
         NONAPPEALABLE JUDGMENT OF A COURT OF COMPETENT JURISDICTION.

AGENTS, PARTNERS AND EMPLOYEES OF COLLATERAL AGENT.

         The  Collateral  Agent may execute any of its duties under the Security
Agreement  by  or  through  its  agents,  partners  or  employees.  Neither  the


                                       30


Collateral  Agent nor any of its agents,  partners or employees  shall be liable
for any  action  taken or omitted  to be taken by it or them in good  faith,  be
responsible  for the  consequence  of any  oversight  or  error of  judgment  or
answerable for any loss unless any of the foregoing  shall happen through its or
their gross negligence or willful  misconduct as shall have been determined in a
final nonappealable judgment of a court of competent jurisdiction.

RELIANCE ON CERTAIN DOCUMENTS.

         The  Collateral  Agent shall be entitled to rely on any  communication,
instrument or document believed by it to be genuine and correct and to have been
signed or sent by the proper  Person or Persons,  and with  respect to all legal
matters shall be entitled to rely on the advice of legal advisors selected by it
concerning  all  matters  relating  to the  Security  Agreement  and its  duties
hereunder and  thereunder  and otherwise  shall rely on such experts as it deems
necessary  or  desirable,  and shall  not be  liable to any  Holder or any other
Person for the consequences of such reliance.

COLLATERAL AGENT MAY HAVE SEPARATE RELATIONSHIP WITH OBLIGATION PARTIES.

         The  Collateral  Agent  may,  notwithstanding  the fact  that it is the
Collateral  Agent,  generally engage in any kind of business with any such party
in the same manner and to the same  effect as though it were not the  Collateral
Agent;  and such business shall not constitute a breach of any obligation of the
Collateral Agent to the other Holders.

INDEMNIFICATION OF COLLATERAL AGENT.

         Each of the Holders  agrees to indemnify the  Collateral  Agent for any
and all liabilities,  losses, damages,  penalties,  actions,  judgments,  suits,
costs,  expenses or disbursements of any kind and nature  whatsoever that may be
imposed on, incurred by or asserted against the Collateral Agent in its capacity
as the Collateral  Agent,  in any way relating to or arising out of the Security
Agreement or the transactions  contemplated hereby or thereby or the enforcement
of any of the terms hereof or thereof or of any such other  documents,  PROVIDED
that no Holder shall be liable for any of the foregoing to the extent they arise
from gross negligence or willful  misconduct on the part of the Collateral Agent
as shall have been  determined in a final  nonappealable  judgment of a court of
competent jurisdiction.  This Section 6.06 shall survive the termination of this
Purchase  Agreement.  Prior to taking any action hereunder as Collateral  Agent,
the Collateral  Agent may require each Holder to deposit with it sufficient sums
as it determines in good faith is necessary to protect the Collateral  Agent for
costs and expenses  associated with taking of action,  and the Collateral  Agent
shall have no  liability  hereunder  for failure to take such action  unless the
Holders promptly deposit such sums.

EVENTS OF DEFAULT

BANKRUPTCY, ETC.

If the Issuer shall commence any case,  proceeding or other action (i) 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


                                       31


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  (ii)  seeking  appointment  of a  receiver,  trustee,
custodian or other similar official for it or for all or any substantial part of
its assets, or the Issuer shall make a general assignment for the benefit of its
creditors;  or (iii)  there  shall be  commenced  against  the  Issuer any case,
proceeding  or other action of a nature  referred to in clause (i) or (ii) 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 (iv)  there  shall be  commenced  against  the  Issuer 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 not have been  vacated,  discharged,  or stayed or bonded  pending  appeal
within 60 days from the entry  thereof;  or (v) the Issuer 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),  (iii),  or (iv) above;  the
Notes  (with  accrued  interest  thereon as provided in the Notes) and all other
amounts  owing under this  Purchase  Agreement  and the Notes shall  immediately
become  due and  payable  without  the need for any  notice  or other  action by
Holders.

OTHER EVENTS.

If any of the following events shall occur and be continuing:

                                       32


     THE  ISSUER  SHALL FAIL TO PAY (I) ANY  PRINCIPAL  OF THE NOTES WHEN DUE IN
     ACCORDANCE WITH THE TERMS THEREOF, OR (II) INTEREST ON THE NOTES OR ANY FEE
     OR OTHER  AMOUNT  PAYABLE  HEREUNDER  WITHIN 5  BUSINESS  DAYS  WHEN DUE IN
     ACCORDANCE WITH THE TERMS THEREOF OR HEREOF; OR

     ANY  REPRESENTATION  OR WARRANTY  MADE BY THE ISSUER HEREIN OR IN ANY OTHER
     PURCHASE  DOCUMENT OR WHICH IS  CONTAINED IN ANY  CERTIFICATE,  DOCUMENT OR
     FINANCIAL OR OTHER  STATEMENT  FURNISHED AT ANY TIME UNDER OR IN CONNECTION
     WITH THIS PURCHASE AGREEMENT OR OTHER PURCHASE DOCUMENT SHALL PROVE TO HAVE
     BEEN INCORRECT AND THE SUBJECT OF THAT BREACH OF REPRESENTATION OR WARRANTY
     HAS A MATERIAL ADVERSE EFFECT ON OR AS OF THE DATE MADE OR DEEMED MADE; OR

     THE ISSUER SHALL DEFAULT IN THE  OBSERVANCE OR PERFORMANCE OF ANY AGREEMENT
     CONTAINED IN THIS PURCHASE  AGREEMENT OR THE NOTES WHICH AGREEMENT,  BY ITS
     NATURE, MAY NOT BE CURED; OR

     THE ISSUER SHALL  DEFAULT IN THE  OBSERVANCE  OR  PERFORMANCE  OF ANY OTHER
     AGREEMENT  CONTAINED  IN THIS  PURCHASE  AGREEMENT  OR ANY  OTHER  PURCHASE
     DOCUMENTS  (OTHER THAN AS PROVIDED  IN  PARAGRAPHS  (A) THROUGH (C) OF THIS
     SECTION),  AND SUCH DEFAULT SHALL  CONTINUE  UNREMEDIED  FOR A PERIOD OF 30
     DAYS;

     THERE SHALL HAVE OCCURRED AN EVENT OF DEFAULT UNDER THE SECURITY  AGREEMENT
     BY AND BETWEEN THE ISSUER AND THE HOLDERS OF EVEN DATE; OR

     THERE  SHALL  HAVE  OCCURRED  AN EVENT OF  DEFAULT  BY ACS UNDER THE CREDIT
     AGREEMENT OR SECURITY  AGREEMENT  WHETHER OR NOT DECLARED BY THE ISSUER, OR
     ANY DEFAULT UNDER OR  TERMINATION  OF THE ASSET  PURCHASE  AGREEMENT BY AND
     AMONG THE ISSUER, ACS AND THE STOCKHOLDERS  SIGNATORY THERETO,  DATED AS OF
     SEPTEMBER 23, 2002, AS AMENDED AND RESTATED ON APRIL 10, 2003;
         then,  and in any such  event,  the  Required  Holders may by notice of
default to the  Issuers,  declare the Notes (with  accrued  interest  thereon as
provided in the Notes) and all other amounts owing under this Purchase Agreement
and  the  Notes  to be due and  payable  forthwith,  whereupon  the  same  shall
immediately become due and payable.


WAIVERS OF PRESENTMENT, ETC.

Except as expressly provided above in this Section, presentment, demand, protest
and all other notices of any kind are hereby expressly waived.

MISCELLANEOUS

AMENDMENTS AND WAIVERS.

No provision of this Purchase Agreement, the Notes or the Purchase Documents may
be waived,  modified or amended  without the prior written  agreement of Holders


                                       33


and the Issuer.  No such waiver,  modification  or amendment  shall extend to or
affect any obligation not expressly waived, modified or amended.

NOTICES.

All notices, requests and demands to or upon the respective parties hereto to be
effective shall be in writing,  and, unless otherwise expressly provided herein,
shall be deemed to have been duly given or made when  delivered by hand,  or, in
the case of telecopy  notice,  when  received,  or, in the case of a  nationally
recognized  courier  service,  one business  day after  delivery to such courier
service,  addressed  as follows in the case of the Issuer and the  Holders or to
such other address as may be hereafter notified by the respective parties hereto
and any future holders of the Notes:

   The Issuer:                  Patient Infosystems, Inc.
                                46 Prince Street
                                Rochester, New York 14607
                                Attn: Kent Tapper

   The Holders:                 To the addresses indicated on SCHEDULE A hereto.


NO WAIVER; CUMULATIVE REMEDIES.

No failure to exercise  and no delay in  exercising,  on the part of any Holder,
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, remedy, power or privilege.  The rights,  remedies,
powers and  privileges  herein  provided are cumulative and not exclusive of any
rights, remedies, powers and privileges provided by law.

SURVIVAL OF REPRESENTATIONS AND WARRANTIES.

Unless  otherwise  provided  herein,  all  representations  and warranties  made
hereunder or under any other Purchase Document and in any document,  certificate
or statement  delivered pursuant hereto or in connection  herewith shall survive
for a period of two years  following the execution and delivery of this Purchase
Agreement and the Notes and Stock.

                                       34


PAYMENT OF EXPENSES, TAXES AND BROKERS' FEES.

The Issuer  agrees that on the Closing  Date it shall (i) pay or  reimburse  the
Holders for all their  out-of-pocket  costs and expenses  incurred in connection
with  the  development,   preparation  and  execution  of,  and  any  amendment,
supplement or modification to, this Purchase Agreement, the Notes, and the other
Purchase  Documents and any other documents  prepared in connection  herewith or
therewith,   and  the  consummation  and   administration  of  the  transactions
contemplated  hereby and  thereby,  provided  that any legal fees of the Holders
shall be  limited to the  reasonable  fees and  disbursements  of counsel to the
Holders,  (ii) pay or  reimburse  each  Holder  for all its costs  and  expenses
incurred in connection  with the enforcement or preservation of any rights under
this Purchase  Agreement,  the Notes, the other Purchase  Documents and any such
other documents,  (iii) pay, indemnify,  and hold each Holder harmless from, any
and all recording and filing fees and any and all  liabilities  with respect to,
or resulting from any delay in paying,  stamp,  excise and other taxes,  if any,
which  may be  payable  or  determined  to be  payable  in  connection  with the
execution  and  delivery of, or  consummation  or  administration  of any of the
transactions  contemplated by, or any amendment,  supplement or modification of,
or any waiver or consent  under or in respect of, this Purchase  Agreement,  the
Notes, the other Purchase  Documents and any such other documents,  and (iv) the
Issuer shall be solely  responsible  for the payment of any brokerage or similar
fees which may become due as the result of the  consummation of the transactions
contemplated by this Purchase Agreement.

COUNTERPARTS.

         This  Purchase  Agreement may be executed by one or more of the parties
to this Purchase  Agreement on any number of separate  counterparts,  and all of
said counterparts  taken together shall be deemed to constitute one and the same
instrument.

SEVERABILITY.

         Any  provision  of this  Purchase  Agreement  which  is  prohibited  or
unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective
to the extent of such prohibition or unenforceability  without  invalidating the
remaining provisions hereof, and any such prohibition or unenforceability in any
jurisdiction shall not invalidate or render  unenforceable such provision in any
other jurisdiction.

INTEGRATION.

This Purchase Agreement and the other Purchase Documents represent the agreement
of the Issuer and the Holders with  respect to the subject  matter  hereof,  and
there  are no  promises,  undertakings,  representations  or  warranties  by the
Holders relative to subject matter hereof not expressly set forth or referred to
herein or in the other Purchase Documents.

GOVERNING LAW.

THE PUCHASE  DOCUMENTS AND THE RIGHTS AND  OBLIGATIONS  OF THE PARTIES UNDER THE
PURCHASE  DOCUMENTS  SHALL BE GOVERNED  BY, AND  CONSTRUED  AND  INTERPRETED  IN
ACCORDANCE  WITH,  THE LAW OF THE  STATE OF IOWA  WITHOUT  GIVING  EFFECT TO THE
CONFLICT OF LAWS RULES THEREOF.

                                       35


WAIVERS OF JURY TRIAL.

THE ISSUER AND ANY HOLDERS HEREBY IRREVOCABLY AND UNCONDITIONALLY WAIVE TRIAL BY
JURY IN ANY LEGAL ACTION OR  PROCEEDING  RELATING TO THE PURCHASE  DOCUMENTS AND
FOR ANY COUNTERCLAIM THEREIN.


                                       36


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

                                            Patient Infosystems, Inc.


                                            By:  ________________________

                                            Name:  Roger Chaufournier

                                            Title: President



                                            Principal Life Insurance Company


                                            By:  ________________________

                                            Name:

                                            Title:

                                            ------------------------
                                            John Pappajohn, Individually



                                            Ann Pappajohn Inter Vivos Trust


                                            By:  ________________________

                                            Name:

                                            Title:

                                       37


                                            Pappajohn  Shriver  Eide  Nicolas PC
                                            Profit  Sharing Plan FBO Socrates G.
                                            Pappajohn


                                            By:  ________________________

                                                   Name:

                                                   Title:


                                       38



                                 Exhibit 2.01(a)

                                      NOTE

                             DUE SEPTEMBER 30, 2003
                                                                      $(insert)

        Patient  Infosystems,  Inc., a corporation duly formed under the laws of
the State of Delaware,  (the "Issuer"),  for value received,  hereby jointly and
severally  promise to pay to (insert) or registered  assigns (the  "Holder") the
principal sum of (insert) ($(insert),  together with  interest,  in the manner
provided  herein.  This Note (this  "Note") was issued  pursuant to that certain
Note and Stock  Purchase  Agreement  dated April __, 2003 between the Issuer and
the investors  listed on SCHEDULE A thereto (the "Purchase  Agreement"),  and is
entitled to the  benefits of the  Purchase  Agreement.  Except as to those terms
otherwise  defined in this Note, all  capitalized  terms used in this Note shall
have the respective meanings ascribed to them in the Purchase Agreement.

              PAYMENTS.

        All principal  amounts then outstanding and unpaid under this Note shall
be paid in full on September 30, 2003 (the "Maturity Date").

              INTEREST.

Interest shall accrue on the Prime Rate plus 3% per annum, computed on the basis
of a 360-day year  counting the actual  number of days  elapsed.  The Prime Rate
means the prime rate as published from time to time by the Wall Street  Journal.
Interest  shall be payable upon the Maturity Date or sooner upon the  occurrence
of certain events as set forth in the Purchase Agreement.

              CONVERSION.

This Note may be convertible at the option of the Holder into shares of Series D
Convertible  Preferred  Stock of the Issuer  upon  consummation  of the  private
placement of such Series D Convertible  Preferred  Stock as  contemplated by the
Asset  Purchase  Agreement  by  and  among  the  Issuer,   American   CareSource
Corporation and certain of their stockholders dated as of September 23, 2002, as
amended on April ___,  2003.  Upon  conversion,  the Holder  shall  receive such
number of shares of Series D Convertible  Preferred Stock of the Issuer as shall
equal the  outstanding  balance of principal and interest due  outstanding  upon
this Note on the date of  conversion.  The  Issuer  has the  option to refuse to
issue  fractional  shares of Series D Convertible  Preferred Stock in which case
the Holder shall receive cash in lieu of such fractional shares.

                                       39


              DEFAULT.

In case an Event of Default  shall occur and be  continuing,  the entire  unpaid
principal  and  interest  accrued to the date of payment of this Note may become
due and  payable  in the manner and with the  effect  provided  in the  Purchase
Agreement.  The Issuer  further  agrees to pay the Holders  fees and expenses as
provided for in the Purchase Agreement.

              PREPAYMENT.

This Note may be prepaid,  in whole or in part, at any time,  without premium or
penalty with the written consent of the Holders.

                                       40


    MISCELLANEOUS.

(A) THE ISSUER WILL PAY TO THE HOLDER,  IN IMMEDIATELY  AVAILABLE  FUNDS TO SUCH
ACCOUNT AS THE HOLDER MAY SPECIFY IN WRITING,  ALL AMOUNTS PAYABLE TO THE HOLDER
IN RESPECT OF THE  PRINCIPAL,  INTEREST  OR OTHER  AMOUNTS  DUE UNDER THIS NOTE,
WITHOUT ANY  PRESENTATION OF THIS NOTE. EACH SUCH PAYMENT,  WHEN PAID,  SHALL BE
APPLIED FIRST TO THE FEES AND CHARGES DUE UNDER THIS NOTE, SECOND TO THE PAYMENT
OF  INTEREST  ACCRUED  AND UNPAID ON THIS NOTE,  AND THIRD TO THE PAYMENT OF THE
PRINCIPAL HEREOF. ALL PAYMENTS HEREUNDER SHALL BE MADE AT THE HOLDER'S PRINCIPAL
OFFICES.  ALL CALCULATIONS AND APPLICATIONS OF AMOUNTS DUE ON ANY DATE,  WHETHER
BY ACCELERATION OR OTHERWISE,  WILL BE MADE BY THE HOLDER,  AND THE ISSUER AGREE
THAT ALL SUCH  CALCULATIONS  AND  APPLICATIONS  WILL BE  CONCLUSIVE  AND BINDING
ABSENT MANIFEST ERROR.

THIS NOTE IS SECURED BY THE  COLLATERAL  AND OTHER ASSETS,  PROPERTY  RIGHTS AND
INTERESTS AS DESCRIBED IN THE PURCHASE AGREEMENT.

THE ISSUER AND ALL  SURETIES,  INDORSERS  AND  GUARANTORS  OF THIS NOTE,  TO THE
EXTENT NOT PROHIBITED BY APPLICABLE  LAW OR REGULATION,  HEREBY WAIVE AS TO THIS
DEBT OR ANY RENEWAL, MODIFICATION, EXTENSION OR REFINANCING THEREOF: (A) DEMAND,
PRESENTMENT,  NOTICE  OF  NON-PAYMENT,  PROTEST,  NOTICE OF  PROTEST,  NOTICE OF
DISHONOR,  ALL OTHER NOTICE, SUIT AGAINST ANY PARTY,  DILIGENCE IN COLLECTION OF
THIS NOTE, THE RELEASE OF ANY PARTY  PRIMARILY OR SECONDARILY  LIABLE THEREON OR
ANY COLLATERAL PLEDGED AS SECURITY, AND ALL OTHER REQUIREMENTS NECESSARY TO HOLD
ISSUER LIABLE HEREUNDER; AND (B) AGREE AND CONSENT TO ANY ONE OR MORE EXTENSIONS
OR POSTPONEMENTS  OF TIME OF PAYMENT OF THIS NOTE OR ANY OTHER  INDULGENCES WITH
RESPECT  HERETO,  WITHOUT NOTICE THEREOF TO ANY OF THEM, AND WITHOUT  RELEASE OF
LIABILITY AS TO ISSUER OR ANY OF THEM.

THIS NOTE HAS BEEN ISSUED AND IS TO BE  PERFORMED IN THE STATE OF IOWA AND SHALL
BE GOVERNED BY AND  CONSTRUED  AND ENFORCED IN  ACCORDANCE  WITH THE LAWS OF THE
STATE OF IOWA  WITHOUT  REGARD  TO  PRINCIPLES  OF  CONFLICTS  OF  LAWS.  IF ANY
PROVISION  HEREOF IS IN CONFLICT WITH ANY STATUTE OR RULE OF LAW OF THE STATE OF
IOWA  OR  ANY  OTHER  STATE,  OR  IS  OTHERWISE  UNENFORCEABLE  FOR  ANY  REASON
WHATSOEVER,  THEN SUCH  PROVISION  SHALL BE DEEMED  SEPARABLE FROM AND SHALL NOT
INVALIDATE ANY OTHER PROVISION OF THIS NOTE.

THE ISSUER WAIVES ANY AND ALL RIGHTS THAT IT MAY NOW OR HEREAFTER HAVE UNDER THE
LAWS OF THE UNITED STATES OF AMERICA OR ANY STATE, TO A TRIAL BY JURY OF ANY AND
ALL ISSUES  ARISING  EITHER  DIRECTLY OR  INDIRECTLY IN ANY ACTION OR PROCEEDING
BETWEEN THE ISSUER AND THE HOLDER OR ITS  SUCCESSORS  AND ASSIGNS,  OUT OF OR IN
ANY WAY  CONNECTED  WITH  THIS  NOTE AND THE  OTHER  PURCHASE  DOCUMENTS.  IT IS
INTENDED  THAT SAID WAIVER SHALL APPLY TO ANY AND ALL DEFENSES,  RIGHTS,  AND/OR
COUNTERCLAIMS  IN  ANY  ACTION  OR  PROCEEDINGS.  THIS  SECTION  IS  A  MATERIAL
INDUCEMENT  TO THE HOLDER TO ENTER  INTO THE  TRANSACTIONS  CONTEMPLATED  BY THE
PURCHASE AGREEMENT.

                                       41


IN WITNESS  WHEREOF,  the Issuer has caused  this Note to be duly  executed  and
delivered.

DATED: _____________, 2003                           PATIENT INFOSYSTEMS, INC.

                                                     BY: EXHIBIT DO NOT SIGN

                                       42


                                 Exhibit 2.01(b)

              CERTIFICATE OF DESIGNATIONS, POWERS, PREFERENCES AND

               RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL

       RIGHTS, AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS THEREOF

                                     OF THE

                            SERIES D PREFERRED STOCK

                                       OF

                            PATIENT INFOSYSTEMS, INC.



                                       43



                                  Exhibit 5.01

                            PATIENT INFOSYSTEMS, INC.
                      SERIES D CONVERTIBLE PREFERRED STOCK


                          REGISTRATION RIGHTS AGREEMENT



                                       44


                                   SCHEDULE A


                                       HOLDER AND ADDRESS OF HOLDER

                                       Principal Life Insurance Company

                                       Attention:  Dennis Menken

                                       C/o Principal Global Investors, LLC

                                       801 Grand Avenue

                                       Des Moines, Iowa  50392


                                       John Pappajohn

                                       c/o  Equity Dynamics, Inc.

                                       666 Walnut Street, Suite 2116

                                       Des Moines, Iowa  50309


                                       Ann Pappajohn Inter Vivos Trust

                                       C/o Equity Dynamics, Inc.

                                       666 Walnut Street, Suite 2116

                                       Des Moines, Iowa  50309


                                       Pappajohn  Shriver  Eide  Nicolas  PC
                                       Profit  Sharing  Plan FBO Socrates G.
                                       Pappajohn

                                       c/o Socrates Pappajohn

                                       103 East State Street

                                       P.O. Box 1588

                                       Mason City, Iowa  50401-3300



                                       45


                                  SCHEDULE 2.01



                      Sale and Purchase of Notes and Stock.

               Allocation of Notes and Shares of Stock to Holders



HOLDER AND ADDRESS OF HOLDER            NOTE AMOUNT            SHARES OF STOCK


Principal Life Insurance Company

Attention:  Dennis Menken

C/o Principal Global Investors, LLC

801 Grand Avenue

Des Moines, Iowa  50392                 $1,500,000.00               106,989


John Pappajohn

c/o  Equity Dynamics, Inc.

666 Walnut Street, Suite 2116

Des Moines, Iowa  50309                 $  900,000.00                84,007


Ann Pappajohn Inter Vivos Trust

C/o Equity Dynamics, Inc.

666 Walnut Street, Suite 2116

Des Moines, Iowa  50309                 $   50,000.00                 3,566



                                       46



Pappajohn   Shriver   Eide   Nicolas  PC  Profit
Sharing Plan FBO Socrates G. Pappajohn

c/o Socrates Pappajohn

103 East State Street

P.O. Box 1588

Mason City, Iowa  50401-3300


                                        $   50,000.00                 3,566
                                           ----------                 -----


Total                                   $2,500,000.00               198,128
                                        =============               =======



                                       47



                                  SCHEDULE 3.05



                          Options Warrants Rights, Etc.


1.   The Company has 1,115,140 incentive stock option grants outstanding.


2.   The Company has no warrants outstanding.


3.   The Company has agreed to convert  Debt owed to John  Pappajohn  and Derace
     Schaffer into Common Stock.


4.   The  Company  has  100,000  shares  of Series C 9%  Cumulative  Convertible
     Preferred Stock outstanding.


                                       48



                                  SCHEDULE 3.11


                                Changes or Events


a)   None.

b)   None.

c)   Termination  of  Contracts  by  AstraZeneca  effective  January 1, 2003 and
     WellPoint effective July 1, 2003.

d)   None.

e)   None.

f)   Dividends  accrued  but  not  declared  on  the  outstanding  Series  C  9%
     Cumulative Convertible Preferred.


                                       49


                                 SCHEDULE 3.13


                             Liens and Encumbrances


Security Agreements, pledging all the assets of the Issuer to:

         John Pappajohn

         Derace Schaffer

         Wells Fargo of Iowa, N.A.



These parties have entered into a Lien Subordination Agreement.



                                       50



                                  SCHEDULE 3.15


                       Agreements, Plans and Arrangements


a)   Premise Lease with Conifer,  Copier Lease with  CitiCorp,  Equipment  Lease
     with Pitney Bowes

b)   A license have been granted by the Issuer to Greater Rochester  Independent
     Practice  Association  for it software  product  "Case  Management  Support
     System."  The Issuer has  obtained  licenses  for  Meridian  software  from
     NORTEL, Centramax software from McKesson.

c)   Letters of  agreement  with Nancy Cox and Patrice  Sminkey  committing  the
     Issuer to 6 months severance upon termination of employment by the Issuer.

d)   None.

e)   None.

f)   Directors  and Officers  insurance  underwritten  by  Navigators  Insurance
     Company,   Fiduciary  Liability  insurance  underwritten  Legion  Insurance
     Company, General Liability and Worker Compensation underwritten by St. Paul
     Insurance  Company  and  Medical  Professional  Liability  underwritten  by
     Admiral Insurance Company.

g)   Reselling agreements exist with CBCA (formerly USI Administrators),  Future
     Health, Medecisions and American Care Source.

h)   The Issuer  accepts  liability  for its wholly  owned  subsidiary,  Patient
     Infosystems Canada, Inc.

i)   None other than those  contemplated  and to be  executed  at even date with
     this agreement.

j)   None.

k)   As shown in Schedule 3.13.

l)   The  Issuer has an  employee  incentive  stock  option  plan and  maintains
     accrued vacation and commission liability on its balance sheet.

m)   None.

n)   None.

                                       51


o)   None.

p)   None.

                                       52


                                    EXHIBIT D

                               CREDITOR AGREEMENT

                            PATIENT INFOSYSTEMS, INC.

         This  creditor  agreement  ("Agreement")  is made this 8th day of April
2003  among John  Pappajohn  ("Pappajohn"),  Principal  Life  Insurance  Company
("Principal"),   Ann  Pappajohn  Intervivos  Trust  (  "Pappajohn  Trust"),  and
Pappajohn Shriver Eide Nicholas PC Profit Sharing Plan FBO Socrates G. Pappajohn
("Pappajohn Profit Sharing Plan").  Pappajohn,  Principal,  Pappajohn Trust, and
Pappajohn  Profit  Sharing  Plan  are  herein  collectively  referred  to as the
"Investors" and individually as an "Investor" in their capacity as Holders under
certain  promissory notes and a certain Note and Stock Purchase Agreement ("Note
Agreement")  made  to  Patient   Infosystems,   Inc.,  a  Delaware   corporation
("Borrower").

RECITALS

         WHEREAS, the Borrower has requested that the Investors purchase certain
notes and stock of Borrower for an Aggregate  Purchase price of $2,500,000.00 on
terms and conditions set forth in said Note Agreement. The Borrower would not be
able to continue its business  without  receiving such  financing.  Borrower has
requested  that the Investors  make such an investment  pursuant to the terms of
the Note Agreement.

         WHEREAS,  the Borrower needed to obtain new financing of  $2,500,000.00
on certain terms and conditions as is set forth in the Note Agreement.

         WHEREAS,   each   Investor  has  loaned  moneys  in  the  aggregate  of
$2,500,000.00  under the Note  Agreement , and commits to convert such loan into
the Series D Convertible  Preferred  Stock of the Borrow (the "Series D") at the
closing of the Asset  Purchase  Agreement by and among the Borrower and American
Care Source dated as of September 23, 2002, as further amended on April __, 2003
(the "Asset Purchase Agreement"), to the following extent:

                                       53


INVESTORS                 DOLLARS LOANED                PROPORTIONATE SHARE
---------                ----------------             -----------------------

Pappajohn                $  900,000.00                          36.00%

Principal                $1,500,000.00                          60.00%

Pappajohn Trust          $   50,000.00                           2.00%

Pappajohn Profit
Sharing Plan             $   50,000.00                           2.00%
                         ----------------                      --------

Total                    $2,500,000.00                         100.0%


         Pursuant to  individual  Promissory  Notes which are a part of the Note
Agreement, and pursuant to the Series D funding plan for the Borrower; and

         WHEREAS,  it is the Investors' desire to execute this Agreement for the
purpose of defining the respective pro rata and  proportionate  share rights and
in defining their respective rights with respect to the Borrower's assets;



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

         1. PROMISE TO CONVERT;  SERIES D. Each Investor  promises each of other
Investor  hereunder  that  he  will  convert  his  proportionate  share  of  the
Promissory  Notes in the Series D financing at the closing of the Asset Purchase
Agreement.  Any investor who did convert his Promissory Notes into in the Series
D shall have all rights under the  provisions  of this  agreement to demand from
the non converting Investor to perform under this Agreement.

         2. PROMISE TO PAY;  INDEMNIFICATION.  Each Investor promises each other
Investor that he will pay, on demand, his proportionate  share to one or more of
the other Investors who have not recovered in proportion  under the Note, but in
no event shall the  proportionate  share of any Investor  exceed the  percentage
amount of the  proportionate  share described above. The demand for payment made


                                       54


by any Investor to any other Investor  shall be made in writing,  accompanied by
proof of the demanding party's disproportionate loss.

         3. CONTRIBUTION. The Investors, as holders of the notes, agree that the
priorities  of the security  interest  which secure their  respective  notes and
their rights in and to the  collateral  shall be equal and that each shall share
and be equal in priority and rights with the other. The Investors  further agree
that if any of them shall,  through the  exercise of any right of  counterclaim,
set-off or otherwise, receive payment of a proportion of the aggregate amount of
principal  and  interest  then due with respect to all of the Notes held by such
Investor and other  amounts then due to such Investor  under the Note  Agreement
(collectively,  the "Aggregate Amounts Due" to such Investor),  which is greater
than the  proportion  received by the other Investor in respect to the Aggregate
Amounts  Due  to  such  other  Investor,   then  the  Investor   receiving  such
proportionately  greater  payment  shall (y) notify the other  Investor  of such
receipt  and (z)  purchase  participations  (which  it shall be  deemed  to have
purchased from the seller  simultaneously upon the receipt by such seller of its
portion of such payment) in the Aggregate  Amounts Due to the other  Investor so
that all such  recoveries  of  Aggregate  Amounts  Due  shall be  shared  by the
Investors in proportion to the Aggregate Amounts Due them;  provided that if all
or part of such  proportionately  greater  payment  received by such  purchasing
Investor is thereafter  recovered  from such  Investor,  such purchase  shall be
rescinded and the purchase price paid for such  participation  shall be returned
to that Investor to the extent of such recovery, but without interest.

         4. LEGAL FEES, COSTS AND EXPENSES.  A defaulting party will, on demand,
indemnify  and hold  harmless  the other party for and  against  all  reasonable
out-of-pocket  expenses,  including  legal fees  incurred by such other party by
reason of enforcement and protection of its rights under this agreement.

         5.  TERMINATION  UPON  CONVERSION  TO  EQUITY.  Upon  conversion  by an
Investor of his  investment  into Series D of the Borrower,  or any other equity
investment  of  the  Borrower  permitted  by  separate  agreement  of all of the
undersigned,  that  converting  Investors  rights  and  obligations  under  this
agreement shall terminate.  The proportionate share of remaining Investors shall
be readjusted to reflect the withdrawal of any such converting Investors.

                                       55


         6. MISCELLANEOUS.  This agreement may be executed in counterpart.  This
agreement  remains in full force and effect  even if the  underlying  promissory
notes, security agreements,  financing  statements,  or other documents executed
between the company and the Investors are extended,  modified, or changed in any
way. It is the intent of the parties that if additional financing is obtained by
the company  pursuant to  essentially  the same  agreement,  that this agreement
remains in full force and effect.

         This agreement may be specifically  modified only by written  agreement
and cannot be  assigned  without  the express  written  permission  of the other
parties to this agreement.

         Words and phrases  contained  in this  agreement  shall be construed as
singular or plural in number and in the masculine,  feminine or neutered  gender
according to the context in which such words and phrases appear.

         This agreement shall be construed under the laws of the State of Iowa.

         If for any reason any provision of this agreement  shall be inoperative
by the validity and effect of other provisions shall not be affected thereby.

         This  agreement may be executed in one or more  identical  counterparts
which when executed by all parties shall  constitute one and the same agreement.
The  Investors  may accept this  agreement  by sending an  executed  copy of the
signature  page by telefax to each other  secured party and by forwarding on the
same to the other parties originally executed signature pages.

         This writing contains the entire  agreement of the parties,  integrates
all terms and  conditions  mentioned and are  incidental  to this  agreement and
supercedes  all  prior   negotiations   and  writings  and  any  other  previous
understanding  regarding the parity  between the parties to this  agreement.  No
modifications  or  waiver of any  provisions  of this  agreement  shall be valid
unless signed in writing by all parties hereto.



                                       56


         The remainder of this page has been left blank intentionally.


                                       57



         IN WITNESS WHEREOF, the parties hereto have caused this agreement to be
executed, as of the date first above written.



PRINCIPAL LIFE INSURANCE COMPANY



By:  _______________________________

     Name:  Dennis J. Menken

     Title:  Portfolio Manager





By:  _______________________________

     Name:

     Title:






     ----------------------------------

     John Pappajohn




                                       58



     Ann Pappajohn Intervivos Trust



By:  ______________________________

     Authorized Agent

     Pappajohn  Shriver  Eide  Nicholas PC Profit  Sharing  Plan FBO Socrates G.
     Pappajohn


By:
     ---------------------------------------
     Authorized Agent



                                       59