NONQUALIFIED STOCK OPTION AGREEMENT
AMERICAN HOMEPATIENT, INC. (the “Corporation”), a Delaware corporation, hereby grants to
____________ (“Holder”) an option to purchase from the Corporation ____________ (______) fully paid and
nonassessable shares of the common stock, $.01 par value, of the Corporation at an exercise price of
$_________ per share. This option has been granted pursuant to the Amended and Restated 1991 Nonqualified
Stock Option Plan (the “Plan”) of the Corporation adopted by its Board of Directors on February 25, 2004, and
is subject to all of the terms, conditions and provisions of the Plan. A copy of the Plan is attached hereto and
made a part of this Option Agreement as if fully set out herein. The ability to exercise some or all of the options
granted may be contingent upon obtaining the requisite approval of the Corporation’s shareholders to increase
the number of shares of common stock issuable under the Plan.
This option shall be exercisable by the Holder in whole or in part as set forth in the chart below, but in no case
may the Holder exercise this option for a fraction of a share. No option will be exercisable after the expiration
date set forth below.
The Holder may exercise the option granted hereunder, in whole or in part, by giving not less than five
(5) days’ written notice of exercise to the Corporation, specifying the number of shares to be purchased and the
person in whose name the stock certificate or certificates for shares of common stock is to be registered, signed
by the Holder, and accompanied by payment of the full purchase price therefor. The option price shall be payable
immediately upon the exercise of this option in United States dollars, paid in cash or by check, with unrestricted
shares of Common Stock of the Corporation valued at Fair Market Value on the date of exercise of this option,
or a combination thereof.
The number of shares of common stock covered by this option shall