sv4za
Table of Contents

As filed with the Securities and Exchange Commission on October 9, 2007
Registration No. 333-144613
 
 
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Amendment No. 3 to
FORM S-4
Registration Statement under the Securities Act of 1933
STERICYCLE, INC.
(Exact name of registrant as specified in its charter)
         
Delaware   4953   36-3640402
(State or other jurisdiction
of incorporation or organization)
  (Primary Standard Industrial
Classification Code Number)
  (I.R.S. Employer
Identification Number)
28161 North Keith Drive, Lake Forest, Illinois 60045
(847) 367-5910

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Mark C. Miller
President and Chief Executive Officer
Stericycle, Inc.
28161 North Keith Drive, Lake Forest, Illinois 60045
(847) 367-5910

(Name, address, including zip code, and telephone number, including area code, of agent for service)
Copies to:
     
Michael Bonn
Craig P. Colmar
Johnson and Colmar
300 South Wacker Drive, Suite 1000
Chicago, Illinois 60606
(312) 922-1980
  Steven R. Block
Christopher M. McNeill
Block & Garden, LLP
12750 Merit Drive
Park Central VII, Suite 770
Dallas Texas 75251
(214) 866-0990
          Approximate date of commencement of proposed sale of the securities to the public: as soon as practicable after this registration statement becomes effective and after the effective time of the merger of TMW Acquisition Corporation, a wholly-owned subsidiary of the registrant, with and into MedSolutions, Inc., pursuant to the Agreement and Plan of Merger dated July 6, 2007 entered into by the registrant, TMW Acquisition Corporation and MedSolutions, Inc.
          If the securities being registered on this form are being offered in connection with the formation of a holding company and there is compliance with General Instruction G, check the following box. o
          If this form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act, check the following box and list the Securities Act registration number of the earlier effective registration statement for the same offering. o
          If this form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering. o
          The registrant hereby amends this Registration Statement on such date or dates as may be necessary to delay its effective date until the registrant shall file a further amendment which specifically states that this registration statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933 or until the registration statement shall become effective on such date as the Commission, acting pursuant to Section 8(a), may determine.
 
 

 


Table of Contents

The information in this proxy statement/prospectus is not complete and may be changed. Stericycle, Inc. may not issue these securities until the registration statement filed with the Securities and Exchange Commission is effective. This proxy statement/prospectus is not an offer to sell these securities and Stericycle, Inc. is not soliciting offers to buy these securities in any jurisdiction where the offer or sale is not permitted.
(Subject to completion, dated October 9, 2007)
Preliminary Prospectus
Stericycle, Inc.
$40,742,903
4.5% Promissory Notes Due 2014 and
3.5% Promissory Notes (Letter of Credit Supported) Due 2014
[MedSolutions letterhead]
October 10, 2007
Dear MedSolutions, Inc. Shareholder:
     The Board of Directors of MedSolutions, Inc. (“MedSolutions”) has unanimously approved a merger agreement with Stericycle, Inc. (“Stericycle”). If MedSolutions shareholders approve and adopt the merger agreement and the merger is subsequently completed, MedSolutions will merge with a subsidiary of Stericycle and shareholders of MedSolutions will receive (i) $0.50 in cash and (ii) a promissory note in the principal amount of $1.50 for each share of MedSolutions common stock owned.
     You will be asked to vote on the merger proposal at a special meeting of MedSolutions shareholders to be held on November 7, 2007, at 10:00 a.m., Dallas, Texas time, at MedSolutions’ corporate headquarters located at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251. Only holders of record of MedSolutions common stock at the close of business on October 8, 2007, the record date for the special meeting, are entitled to vote at the special meeting.
     After careful consideration, MedSolutions’ Board of Directors has unanimously determined that the merger is advisable and in the best interests of MedSolutions and its shareholders and unanimously recommends that MedSolutions shareholders vote FOR approval and adoption of the merger agreement.
     Your vote is very important. Because approval and adoption of the merger agreement requires the affirmative vote of the holders of a majority of the outstanding shares of MedSolutions common stock entitled to vote at the special meeting, a failure to vote will have the same effect as a vote against approval and adoption of the merger agreement.
     Whether or not you plan to attend the special meeting, please complete, sign, date and return the enclosed proxy card in the enclosed envelope as soon as possible so that your shares are represented at the meeting. This action will not limit your right to vote in person if you wish to attend the special meeting and vote in person.
     This document is a prospectus related to the issuance of the Stericycle promissory notes in connection with the merger and a proxy statement for MedSolutions to use in soliciting proxies for its special meeting of shareholders. Attached to this letter is an important document containing answers to frequently asked questions and a summary description of the merger, followed by more detailed information about MedSolutions, Stericycle, the proposed merger and the merger agreement. We urge you to read this document carefully and in its entirety. In particular, you should consider the matters discussed under “Risk Factors” beginning on page 16 of this proxy statement/prospectus.
     MedSolutions’ Board of Directors very much appreciates and looks forward to your support.
Sincerely,
Matthew H. Fleeger
President and Chief Executive Officer
     Neither the Securities and Exchange Commission nor any state securities commission has approved or disapproved of the securities to be issued in connection with the merger or passed upon the adequacy or accuracy of this proxy statement/prospectus. Any representation to the contrary is a criminal offense.
     This proxy statement/prospectus is dated October 10, 2007 and is first being mailed to shareholders of MedSolutions on or about October 10, 2007.

 


Table of Contents

REFERENCES TO ADDITIONAL INFORMATION
     As used in this proxy statement/prospectus, “Stericycle” refers to Stericycle, Inc. and its consolidated subsidiaries and “MedSolutions” refers to MedSolutions, Inc. and its consolidated subsidiaries, in each case, except where the context otherwise requires or as otherwise indicated. This proxy statement/prospectus incorporates important business and financial information about Stericycle from documents that Stericycle has filed with the Securities and Exchange Commission. Two of these documents have been delivered with this proxy statement/prospectus, but the others have not. For a listing of all documents incorporated by reference into this proxy statement/prospectus, please see the section entitled “Where You Can Find More Information” beginning on page 215 of this proxy statement/prospectus.
     Stericycle will provide you with copies of the documents incorporated by reference, without charge, if you request copies in writing or by telephone from:
Stericycle, Inc.
28161 North Keith Drive
Lake Forest, Illinois 60045
Attention: Investor Relations
(847) 367-5910
     You may also request copies by email to investor@stericycle.com.
     In order for you to receive timely delivery of the documents in advance of the MedSolutions special meeting, Stericycle should receive your request no later than October 31, 2007.
     Delivered with this proxy statement/prospectus are (i) Stericycle’s annual report on Form 10-K for the year ended December 31, 2006 and (ii) its quarterly report on Form 10-Q for the quarter ended June 30, 2007, each as filed with the Securities and Exchange Commission. For convenience, Stericycle’s Form 10-K is referred to in this proxy statement/prospectus as Stericycle’s “2006 Form 10-K” and its Form 10-Q is referred to as its “2007 Second Quarter Form 10-Q.”
     Stericycle has supplied all information contained in this proxy statement/prospectus relating to Stericycle, and MedSolutions has supplied all information contained in this proxy statement/prospectus relating to MedSolutions. Stericycle and MedSolutions have both contributed to information relating to the merger.

 


Table of Contents

MedSolutions, Inc.
NOTICE OF SPECIAL MEETING OF SHAREHOLDERS
TO BE HELD NOVEMBER 7, 2007
TO THE SHAREHOLDERS OF MEDSOLUTIONS, INC.:
     You are cordially invited to attend the special meeting of shareholders of MedSolutions, Inc., a Texas corporation (“MedSolutions”), to be held on November 7, 2007, at 10:00 a.m., Dallas, Texas time, at MedSolutions’ corporate headquarters located at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251. As described in this proxy statement/prospectus, the special meeting will be held for the following purposes:
     1. to consider and vote upon a proposal to approve and adopt the Agreement and Plan of Merger dated as of July 6, 2007, by and among Stericycle, Inc., TMW Acquisition Corporation and MedSolutions, Inc.;
     2. to consider and vote upon a proposal to adjourn or postpone the special meeting, if necessary, to solicit additional proxies in favor of the approval and adoption of the merger agreement; and
     3. to consider and transact any other business as may properly be brought before the special meeting or any adjournments or postponements thereof.
     THE BOARD OF DIRECTORS OF MEDSOLUTIONS HAS CAREFULLY CONSIDERED THE TERMS OF THE MERGER AGREEMENT AND THE MERGER AND BELIEVES THAT THE MERGER IS ADVISABLE AND FAIR TO, AND IN THE BEST INTERESTS OF MEDSOLUTIONS AND ITS SHAREHOLDERS. THE BOARD OF DIRECTORS HAS UNANIMOUSLY APPROVED THE MERGER AGREEMENT AND THE MERGER AND UNANIMOUSLY RECOMMENDS THAT SHAREHOLDERS VOTE FOR APPROVAL OF THE MERGER AGREEMENT.
     The Board of Directors of MedSolutions has fixed the close of business on October 8, 2007 as the record date for the determination of shareholders entitled to notice of, and to vote at, the MedSolutions special meeting or any reconvened meeting following an adjournment or postponement thereof. Only shareholders of record at the close of business on such record date are entitled to notice of and to vote at such meeting. A complete list of such shareholders will be available for examination at the MedSolutions special meeting and at MedSolutions’ offices at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251, during ordinary business hours, after October 8, 2007, for the examination by any such shareholder for any purpose germane to the special meeting.
     It is important that your stock be represented at the special meeting regardless of the number of shares you hold. Please promptly mark, date, sign and return the enclosed proxy in the accompanying envelope, whether or not you intend to be present at the special meeting. See “Information About the Special Meeting and Voting” beginning on page 32. Your proxy is revocable at any time prior to its use at the special meeting.
     Please do not send your MedSolutions common stock certificates with the enclosed proxy. If the merger is completed, the payment agent will send you instructions regarding the surrender of your stock certificates.
By order of the Board of Directors,
Beverly Fleeger
Corporate Secretary
October 10, 2007

 


Table of Contents

TABLE OF CONTENTS
         
    Page
    1  
    9  
    9  
    9  
    10  
    10  
    10  
    11  
    11  
    11  
    12  
    12  
    14  
    15  
    15  
    16  
    26  
    27  
    28  
    30  
    31  
    32  
    32  
    32  
    32  
    32  
    33  
    34  
    34  
    34  
    35  
    35  
    35  
    36  
    36  
    36  
    39  
    40  
    40  
    41  
    45  
    45  
    45  
    48  
    49  
    49  
    49  


Table of Contents

TABLE OF CONTENTS
(con’d)
         
    Page
    50  
    50  
    51  
    54  
    54  
    54  
    55  
    55  
    56  
    57  
    57  
    59  
    62  
    63  
    66  
    67  
    69  
    70  
    70  
    71  
    71  
    71  
    72  
    72  
    72  
    72  
    73  
    73  
    73  
    73  
    73  
    74  
    74  
    75  
    75  
    75  
    76  
    76  
    77  
    77  
    78  
    78  
    96  
    97  
    98  
    98  
    99  
    109  

ii 


Table of Contents

TABLE OF CONTENTS
(con’d)
         
    Page
    110  
    112  
    214  
    214  
    214  
    215  
 Opinion of Johnson & Colmar
 Consent of Ernst & Young, LLP
 Consent of Marcum & Kliegman, LLP
 Consent of Van Amburgh Valuation Associates, Inc.
ANNEXES
     
Annex A
  Agreement and Plan of Merger dated as of July 6, 2007, by and among Stericycle, Inc., TMW Acquisition Corporation, and MedSolutions, Inc.
 
   
Annex B
  First Amendment to Agreement and Plan of Merger dated as of September 28, 2007, by and among Stericycle, Inc., TMW Acquisition Corporation and MedSolutions, Inc.
 
   
Annex C
  Opinion of Van Amburgh Valuation Associates, Inc., dated June 30, 2007
 
   
Annex D
  Appraisal and Dissenters’ Rights under the Texas Business Corporation Act
 
   
Annex E
  Indenture dated as of July 12, 2007 between Stericycle, Inc. and LaSalle Bank National Association as trustee in respect of Stericycle’s 4.5% Promissory Notes due 2014
 
   
Annex F
  Indenture dated as of July 12, 2007 between Stericycle, Inc. and LaSalle Bank National Association as trustee in respect of Stericycle’s 3.5% Promissory Notes (Letter of Credit Supported) due 2014
     No person is authorized to give any information or to make any representation with respect to the matters described in this proxy statement/prospectus other than those contained herein or in the documents incorporated by reference herein and, if given or made, such information or representation must not be relied upon as having been authorized by Stericycle or MedSolutions. This proxy statement/prospectus does not constitute an offer to sell or a solicitation of an offer to buy the securities offered by this proxy statement/prospectus or a solicitation of a proxy in any jurisdiction where, or to any person whom, it is unlawful to make such an offer or solicitation. Neither the delivery hereof nor any distribution of securities made hereunder shall, under any circumstances, create an implication that there has been no change in the affairs of Stericycle or MedSolutions since the date hereof or that the information contained or incorporated by reference into this proxy statement/prospectus is correct as of any time subsequent to the date hereof.

iii 


Table of Contents

QUESTIONS AND ANSWERS ABOUT THE MERGER AND THE SPECIAL MEETING
     The following questions and answers briefly address some commonly asked questions about the special meeting and the merger. They may not include all the information that is important to you. We urge you to read carefully this entire proxy statement/prospectus, including the annexes and the other documents we refer to in this proxy statement/prospectus.
Frequently Used Terms
     We have generally avoided the use of technical defined terms in this proxy statement/prospectus, but a few frequently used terms may be helpful for you to have in mind at the outset. We refer to:
    Stericycle, Inc., a Delaware corporation, as “Stericycle”;
 
    MedSolutions, Inc., a Texas corporation, as “MedSolutions”;
 
    TMW Acquisition Corporation, a newly-formed Texas corporation and a wholly-owned subsidiary of Stericycle, as “Merger Sub”;
 
    the merger of MedSolutions with Merger Sub and the conversion of shares of MedSolutions common stock into the right to receive cash and promissory notes as the “merger”;
 
    the promissory notes to be issued by Stericycle to holders of MedSolutions common stock in connection with the merger as the “promissory notes”;
 
    the Agreement and Plan of Merger dated as of July 6, 2007 by and among Stericycle, Merger Sub and MedSolutions, as amended by a First Amendment to Agreement and Plan of Merger dated as of September 28, 2007, as the “merger agreement”; and
 
    the Texas Business Corporation Act as the “TBCA.”
     In addition, we have already noted that Stericycle’s Form 10-K for the year ended December 31, 2006 is referred to in this proxy statement/prospectus as Stericycle’s “2006 Form 10-K” and its Form 10-Q for the quarter ended March 31, 2007 is referred to as its “2007 Second Quarter Form 10-Q.”
About the Merger
     
Q1:
  What am I voting on?
 
   
A1:
  Stericycle is proposing to acquire MedSolutions. You are being asked to vote to approve and adopt the merger agreement. In the merger, MedSolutions will merge with Merger Sub. MedSolutions would be the surviving corporation in the merger and would become a wholly-owned subsidiary of Stericycle.
 
   
 
  MedSolutions is also seeking your approval of a proposal to adjourn or postpone the special meeting, if necessary, to solicit additional proxies in favor of approval and adoption of the merger agreement and any other matters that may come before the special meeting.
 
   
Q2:
  What will I receive in exchange for my MedSolutions shares?
 
   
A2:
  Upon completion of the merger, you will receive a combination of $0.50 in cash, without interest, and a promissory note in the principal amount of $1.50 for each share of MedSolutions common stock that you own. We refer to the aggregate amount of the cash consideration and note consideration to be received by MedSolutions shareholders pursuant to the merger as the “merger

 


Table of Contents

     
 
  consideration.” The aggregate merger consideration is subject to adjustment after the closing of the merger in certain events. See “The Merger Agreement — Adjustments to Merger Consideration” beginning on page 59 of this proxy statement/prospectus. At the closing of the merger, $125,000 of the aggregate cash consideration will be placed into an escrow account for use by MedSolutions’ shareholder representative for the costs and expenses of fulfilling its duties under the merger agreement. See “The Merger Agreement — Shareholder Representative” beginning on page 62 of this proxy statement/prospectus.
 
   
 
  The promissory notes will be payable in seven installments of interest only due on each of the first seven anniversaries of the date on which the merger closes and one installment of principal due on the seventh anniversary of such closing date, and will bear interest, at the election of each holder of shares of MedSolutions common stock, at the annual rate of either 3.5% (if such shareholder elects to have such promissory note supported by a master letter of credit) or 4.5% (if such shareholder does not elect such support). See “Description of Promissory Notes” beginning on page 71 of this proxy statement/prospectus for a full description of the promissory notes. The promissory notes will be subject to offset or reduction in principal amount pursuant to the merger consideration principal adjustment, litigation payment principal reduction and indemnification provisions of the merger agreement or in the event that the expenses of the payment agent and the indenture trustee exceed $80,000. See “The Merger Agreement — Payment Procedures,” “The Merger Agreement — Representations and Warranties and Indemnification,” and “The Merger Agreement — Adjustments to Merger Consideration” beginning on pages 56, 57 and 59 of this proxy statement/prospectus, respectively.
 
   
Q3:
  Do I have the option to receive all cash consideration or all note consideration for my MedSolutions shares?
 
   
A3:
  No. All MedSolutions shareholders will receive the fixed combination of the cash consideration and the note consideration for each share of MedSolutions common stock that they own.
 
   
Q4:
  What are the tax consequences of the merger to me?
 
   
A4:
  For a discussion of certain material United States federal income tax consequences of the merger, see “Material United States Federal Income Tax Consequences” beginning on page 51 of this proxy statement/prospectus.
 
   
 
  Tax matters are very complicated and the consequences of the merger to any particular MedSolutions shareholder will depend on that shareholder’s particular facts and circumstances. You are urged to consult your own tax advisor to determine your own tax consequences from the merger.
 
   
Q5:
  What is the required vote to approve and adopt the merger agreement?
 
   
A5:
  Holders representing a majority of the outstanding shares of MedSolutions common stock entitled to vote at the special meeting must vote to approve and adopt the merger agreement to complete the merger. No vote of Stericycle stockholders is required in connection with the merger.
 
   
Q6:
  What happens if I do not vote?
 
   
A6:
  Because the required vote of MedSolutions shareholders is based upon the number of outstanding shares of MedSolutions common stock entitled to vote rather than upon the number of shares actually voted, abstentions from voting and “broker non-votes” will have the same effect as a vote

2


Table of Contents

     
 
  AGAINST approval and adoption of the merger agreement. If you return a properly signed proxy card but do not indicate how you want to vote, your proxy will be counted as a vote FOR approval and adoption of the merger agreement and FOR approval of any proposal to adjourn or postpone the special meeting, if necessary, to solicit additional proxies in favor of approval and adoption of the merger agreement.
 
   
Q7:
  How does the MedSolutions Board of Directors recommend I vote?
 
   
A7:
  The Board of Directors of MedSolutions unanimously recommends that MedSolutions’ shareholders vote FOR approval and adoption of the merger agreement. The MedSolutions Board of Directors believes the merger is advisable and in the best interests of MedSolutions and its shareholders.
 
   
Q8:
  Do I have dissenters’ or appraisal rights with respect to the merger?
 
   
A8:
  Yes. Under Texas law, you have the right to dissent from the merger and, in lieu of receiving the merger consideration, obtain payment in cash of the fair value of your shares of MedSolutions common stock as determined by a Texas state court. To exercise appraisal rights, you must strictly follow the procedures prescribed by Article 5.12 of the TBCA. See “The Merger — Appraisal and Dissenters’ Rights” beginning on page 45 of this proxy statement/prospectus. In addition, the full text of the applicable provisions of Texas law dealing with dissenters’ rights is included as Annex D to this proxy statement/prospectus.
 
   
Q9:
  Are there risks associated with the merger that I should consider in deciding how to vote?
 
   
A9:
  Yes. There are risks associated with all business combinations, including the merger of our two companies. There are a number of risks that are discussed in this document and in other documents incorporated by reference into this document. Please read with particular care the more detailed description of the risks associated with the merger discussed under “Risk Factors” beginning on page 16 of this proxy statement/prospectus.
 
   
Q10:
  When do you expect the merger to be completed?
 
   
A10:
  We are working on completing the merger as quickly as possible. To complete the merger, we must obtain the approval of the MedSolutions shareholders and satisfy or waive all other closing conditions under the merger agreement, which we currently expect should occur in the fourth quarter of 2007. However, we cannot assure you when or if the merger will occur. See “The Merger Agreement — Conditions Precedent” beginning on page 66 of this proxy statement/prospectus. If the merger occurs, we will promptly make a public announcement of this fact.
 
   
Q11:
  What will happen to my MedSolutions shares after completion of the merger?
 
   
A11:
  Upon completion of the merger, your shares of MedSolutions common stock will be canceled and will represent only the right to receive your portion of the merger consideration (or the fair value of your MedSolutions common stock if you seek appraisal rights).

3


Table of Contents

     
Q12:
  Who will represent the interests of MedSolutions shareholders under the merger agreement after the effective time of the merger?
 
   
A12:
  Pursuant to the merger agreement, at the effective time of the merger Matthew H. Fleeger, MedSolutions’ President and Chief Executive Officer, and Winship B. Moody, Sr., MedSolutions’ Chairman of the Board, will be appointed as the joint agents and attorneys-in-fact, for the holders of shares of MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates to the payment agent, to give and receive notices and communications and to take any and all action on behalf of such holders pursuant to the merger agreement and in connection with the promissory notes, including without limitation asserting, prosecuting, or settling any claim against the surviving corporation or Stericycle or defending or settling any claim asserted by the surviving corporation or Stericycle. In this capacity, Mr. Fleeger and Mr. Moody are collectively referred to as the “shareholder representative” in this proxy statement/prospectus. By voting to approve and adopt the merger agreement each holder of MedSolutions common stock agrees that the shareholder representative will not be liable to such holder or any other person for any action taken, or declined to be taken, in good faith and in the exercise of reasonable judgment.
 
   
 
  At the closing of the merger, Stericycle will place $125,000 of the aggregate cash merger consideration into an escrow account with Park Cities Bank, Dallas, Texas, which amount will be made available for use by the shareholder representative for the costs and expenses incurred by the shareholder representative in fulfilling its duties under the merger agreement. Such costs and expenses will include $5,000 per year compensation paid to each of Messrs. Fleeger and Moody for their service as shareholder representative. The $125,000 will be deducted on a pro rata basis from the cash consideration distributable to the holders of shares of MedSolutions common stock and holders of options to purchase shares of MedSolutions common stock in connection with the merger. Any funds remaining in such escrow account on the date of the last payment payable under the promissory notes will be remitted to the surviving corporation to the merger to be applied towards the $250,000 payment due with respect to the litigation settlement described in “The Merger Agreement — Litigation Adjustment” on page 61 of this proxy statement/prospectus.
 
   
 
  See “The Merger Agreement — Shareholder Representative” beginning on page 62 of this proxy statement/prospectus.
 
   
About the Special Meeting
 
   
Q13:
  When and where is the MedSolutions special shareholder meeting?
 
   
A13:
  The MedSolutions special shareholder meeting will take place on November 7, 2007, at 10:00 a.m., Dallas, Texas time, at MedSolutions’ corporate headquarters located at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251.
 
   
Q14:
  What will happen at the special meeting?
 
   
A14:
  At the MedSolutions special meeting, MedSolutions shareholders will vote on a proposal to adopt the merger agreement and on a proposal to approve adjournments or postponements of the special meeting, if necessary, to permit further solicitation of proxies if there are not sufficient votes at the time of the special meeting to approve the merger proposal. We cannot complete the merger unless, among other things, MedSolutions’ shareholders vote to adopt the merger agreement.

4


Table of Contents

     
Q15:
  Who is entitled to vote at the special meeting?
 
   
A15:
  Only holders of record of MedSolutions common stock at the close of business on October 8, 2007, which is the date MedSolutions’ Board of Directors has fixed as the record date for the special meeting, are entitled to receive notice of and vote at the special meeting.
 
   
Q16:
  What is a quorum?
 
   
A16:
  A quorum is the number of shares that must be present to hold the meeting. The quorum requirement for the MedSolutions special meeting is one-third of the issued and outstanding shares of MedSolutions common stock as of the record date, present in person or represented by proxy and entitled to vote at the special meeting. A proxy submitted by a shareholder may indicate that all or a portion of the shares represented by the proxy are not being voted with respect to a particular matter. Proxies that are marked “abstain” or for which votes have otherwise been withheld and proxies relating to “street name” shares that are returned to MedSolutions but not voted will be treated as shares present for purposes of determining the presence of a quorum on all matters.
 
   
Q17:
  How many shares can vote?
 
   
A17:
  On the record date, MedSolutions had outstanding 26,458,446 shares of common stock, which constitute MedSolutions’ only outstanding voting securities. Each MedSolutions shareholder is entitled to one vote on each proposal for each share of MedSolutions common stock held as of the record date.
 
   
Q18:
  What vote is required?
 
   
A18:
  The affirmative vote of the holders of a majority of the outstanding shares of MedSolutions common stock entitled to vote at the MedSolutions special meeting is required to adopt the merger agreement. The approval of a proposal to adjourn or postpone the special meeting, if necessary, to permit further solicitation of proxies, if there are not sufficient votes at the time of the special meeting to approve the merger agreement, requires the vote of a majority of shares present in person or by proxy at the special meeting and actually voted at that special meeting.
 
   
 
  If a quorum is not present at the MedSolutions special meeting, the holders of a majority of the shares entitled to vote who are present in person or by proxy at the meeting may adjourn the meeting.
 
   
 
  In conjunction with the execution of the merger agreement, 50 MedSolutions shareholders entered into a voting agreement with Stericycle and Merger Sub which obligates them to vote their shares of common stock “FOR” the merger agreement. As of the record date, the shareholders subject to the voting agreement with Stericycle and Merger Sub were entitled to vote an aggregate of 15,102,594 shares of MedSolutions, which represented approximately 57.1% of the MedSolutions common stock outstanding and entitled to vote as of the record date. Accordingly, the shareholders party to the abovementioned voting agreement may approve the merger on their own vote irrespective of how any other shareholders may vote.
 
 
  Even if there are sufficient votes to approve the merger at the special meeting, we cannot assure you that the merger will be completed, because the completion of the merger is subject to the satisfaction or waiver of other conditions discussed in this proxy statement/prospectus.
 
   

5


Table of Contents

     
Q19:
  What do I need to do now?
 
A19:
  After carefully reading and considering the information contained and referred to in this proxy statement/prospectus, including its annexes, please authorize your shares of MedSolutions common stock to be voted by returning your completed, dated and signed proxy card in the enclosed return envelope as soon as possible. To be sure that your vote is counted, please submit your proxy as instructed on your proxy card even if you plan to attend the special meeting in person. DO NOT enclose or return your stock certificate(s) with your proxy card. If you hold shares registered in the name of a broker, bank or other nominee, that broker, bank or other nominee will provide a voting instruction card for use in directing your broker, bank or other nominee how to vote those shares.
 
   
Q20:
  May I vote in person?
 
   
A20:
  Yes. You may attend the special meeting of MedSolutions’ shareholders and vote your shares in person rather than by signing and returning your proxy card. If you wish to vote in person and your shares are held by a broker, bank or other nominee, you need to obtain a proxy from the broker, bank or nominee authorizing you to vote your shares held in the broker’s, bank’s or nominee’s name.
 
   
Q21:
  If my shares are held in “street name,” will my broker, bank or other nominee vote my shares for me?
 
   
A21:
  Yes, but your broker, bank or other nominee may vote your shares of MedSolutions common stock only if you instruct your broker, bank or other nominee how to vote. If you do not provide your broker, bank or other nominee with instructions on how to vote your “street name” shares, your broker, bank or other nominee will not be permitted to vote them on the merger agreement. You should follow the directions your broker, bank or other nominee provides to ensure your shares are voted at the special meeting.
 
   
Q22:
  May I change my vote?
 
   
A22:
  Yes. You may change your vote at any time before your proxy is voted at the special meeting. If your shares of MedSolutions common stock are registered in your own name, you can do this in one of three ways:
    First, you can deliver to MedSolutions, prior to the special meeting, a written notice stating that you want to revoke your proxy. The notice should be sent to the attention of Ms. Beverly Fleeger, Corporate Secretary, MedSolutions, Inc., 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251, to arrive by the close of business on November 6, 2007.
 
    Second, prior to the special meeting, you can complete and deliver a new proxy card. The proxy card should be sent to Ms. Beverly Fleeger, Corporate Secretary, MedSolutions, Inc., 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251 to arrive by the close of business on November 6, 2007. The latest dated and signed proxy actually received by this addressee before the special meeting will be counted, and any earlier proxies will be considered revoked.
 
    Third, you can attend the MedSolutions special meeting and vote in person. Any earlier proxy will thereby be revoked automatically. Simply attending the special meeting, however, will not revoke your proxy, as you must vote at the special meeting to revoke a prior proxy.
 
      If you have instructed a broker to vote your shares, you must follow directions you receive from your broker to change or revoke your vote.

6


Table of Contents

     
 
  If you are a street-name shareholder and you vote by proxy, you may later revoke your proxy instructions by informing the holder of record in accordance with that entity’s procedures.
 
   
Q23:
  How will the proxies vote on any other business brought up at the special meetings?
 
   
A23:
  By submitting your proxy, you authorize the persons named on the proxy card to use their judgment to determine how to vote on any other matter properly brought before the special meeting. The proxies will vote your shares in accordance with your instructions. If you sign, date and return your proxy without giving specific voting instructions, the proxies will vote your shares “FOR” approval and adoption of the merger agreement and FOR approval of any proposal to adjourn or postpone the special meeting, if necessary, to solicit additional proxies in favor of approval and adoption of the merger agreement. If you do not return your proxy, or if your shares are held in street name and you do not instruct your bank, broker or nominee on how to vote, your shares will not be voted at the special meeting.
 
   
 
  The Board of Directors of MedSolutions does not intend to bring any other business before the meeting, and it is not aware that anyone else intends to do so. If any other business properly comes before the meeting, it is the intention of the persons named on the proxy cards to vote as proxies in accordance with their best judgment.
 
   
Q24:
  What is a broker non-vote?
 
   
A24:
  A “broker non-vote” occurs when a bank, broker or other nominee submits a proxy that indicates that the broker does not vote for some or all of the proposals, because the broker has not received instructions from the beneficial owners on how to vote on these proposals and does not have discretionary authority to vote in the absence of instructions.
 
   
Q25:
  Will broker non-votes or abstentions affect the results?
 
   
A25:
  If you are a MedSolutions shareholder, broker non-votes and abstentions will have the same effect as a vote against the proposal to adopt the merger agreement, but will have no effect on the outcome of the proposal relating to adjournments or postponements of the special meeting, if necessary, to permit further solicitation of proxies. If your shares are held in street name, we urge you to instruct your bank, broker or nominee on how to vote your shares.
 
   
Q26:
  What happens if I choose not to submit a proxy or to vote?
 
   
A26:
  If a MedSolutions shareholder does not submit a proxy or vote at the MedSolutions special meeting, it will have the same effect as a vote against the proposal to adopt the merger agreement, but will have no effect on the outcome of a proposal to adjourn or postpone the special meeting, if necessary, to permit further solicitation of proxies.

7


Table of Contents

     
Q27:
  Why is it important for me to vote?
 
   
A27:
  We cannot complete the merger without holders of a majority of the outstanding shares of MedSolutions common stock entitled to vote voting in favor of the approval and adoption of the merger agreement.
 
   
Q28:
  What happens if I sell my shares of MedSolutions common stock before the special meeting?
 
   
A28:
  The record date for the special meeting is October 8, 2007, which is earlier than the date of the special meeting. If you hold your shares of MedSolutions common stock on the record date you will retain your right to vote at the special meeting. If you transfer your shares of MedSolutions common stock after the record date but prior to the date on which the merger is completed, you will lose the right to receive the merger consideration for shares of MedSolutions common stock. The right to receive the merger consideration will pass to the person who owns your shares of MedSolutions common stock when the merger is completed.
 
   
General
 
   
Q29:
  Should I send in my MedSolutions stock certificates now?
 
   
A29:
  No. PLEASE DO NOT SEND ANY STOCK CERTIFICATES WITH YOUR PROXY CARD. After the merger is completed, you will receive written instructions informing you how to send in your stock certificates to receive the merger consideration.
 
   
Q30:
  What does it mean if I get more than one proxy card?
 
   
A30:
  Your shares are probably registered in more than one account. You should vote each proxy card you receive.
 
   
Q31:
  Where can I find more information about the special meeting, the merger, MedSolutions or Stericycle?
 
   
A31:
  You can find more information about MedSolutions or Stericycle in each of the companies’ respective filings with the Securities and Exchange Commission and, with respect to Stericycle, with the Nasdaq National Market. Information about Stericycle is also available on its website, www.stericycle.com, where many of its filings with the Securities and Exchange Commission can be viewed and downloaded. If you have any questions about the special meeting, the merger or how to submit your proxy, or if you need additional copies of this proxy statement/prospectus or the enclosed proxy card, you should contact MedSolutions at the address or phone number below. If your broker holds your shares, you can also call your broker for additional information.
 
   
 
  MedSolutions, Inc.
 
  12750 Merit Drive
 
  Park Central VII, Suite 770
 
  Dallas, Texas 75251
 
  Attn: Ms. Beverly Fleeger
 
  (972) 931-2374

8


Table of Contents

SUMMARY
     This summary highlights selected information from this proxy statement/prospectus, including material terms of the merger, and may not contain all of the information that is important to you. To understand the merger fully and for a more complete description of the legal terms of the merger, you should carefully read this entire document, including its Annexes, and the documents to which we refer you. See “Where You Can Find More Information” beginning on page 215 of this proxy statement/prospectus.
The Companies (page 76 for Stericycle and page 78 for MedSolutions)
Stericycle, Inc.
28161 North Keith Drive
Lake Forest, Illinois 60045
(847) 367-5910
     Stericycle, Inc., headquartered in Lake Forest, Illinois, is in the business of managing regulated medical waste and providing an array of related services. Stericycle operates in the United States, Canada, Mexico, the United Kingdom, Ireland and Argentina.
MedSolutions, Inc.
12750 Merit Drive
Park Central VII, Suite 770
Dallas, Texas 75251
(972) 931-2374
     MedSolutions, Inc., headquartered in Dallas, Texas, is a diversified holding company that provides complete and effective regulated medical waste management outsource solutions, concentrating in the southern and northeastern portions of the United States.
The Merger (page 36)
     General
     On July 6, 2007, the companies agreed to the merger between MedSolutions and Merger Sub under the terms of the merger agreement described in this proxy statement/prospectus and attached as Annex A as amended by an amendment on September 28, 2007 attached to this proxy statement/prospectus as Annex B. As amended, the merger agreement is the legal document that governs the merger, and we urge you to read that agreement.
     At the effective time of the merger, Merger Sub will merge with and into MedSolutions. MedSolutions will be the surviving corporation in the merger and will become a wholly-owned subsidiary of Stericycle. The separate corporate existence of Merger Sub will cease at the effective time of the merger.
     Exchange of MedSolutions Shares (page 55)
     At the effective time of the merger, each outstanding share of MedSolutions common stock (other than any shares owned directly or indirectly by MedSolutions, Stericycle, or Merger Sub and those shares held by dissenting shareholders) will be converted into the right to receive a combination of $0.50 in cash and a promissory note in the principal amount of $1.50. The promissory notes will be payable with interest only for six years, with a final payment of all principal and accrued and unpaid interest thereon due on the seventh anniversary of the issuance of the promissory notes. The promissory notes will bear interest at the election of each MedSolutions shareholder at the rate per annum of 3.5% or 4.5%. The promissory notes bearing interest at 3.5% will be letter of credit supported and the promissory notes bearing interest at 4.5% will be unsecured. Otherwise, the promissory notes are identical. Pursuant to the merger agreement, Stericycle will pay $13,580,968 in cash and $40,742,903 in principal amount of either 3.5% or 4.5% promissory notes, or an aggregate of $54,323,871 to be paid to the MedSolutions shareholders and optionholders in consideration of the merger. As already noted, we refer to the aggregate

9


Table of Contents

amount of the cash consideration and the note consideration to be received by MedSolutions shareholders pursuant to the merger as the merger consideration. The merger consideration is subject to a downward adjustment by adjusting the aggregate amount that may ultimately be paid under the promissory notes. The aggregate principal amount of the promissory notes ultimately to be paid by Stericycle is subject to offset or reduction pursuant to the merger consideration principal adjustment (see discussion beginning on page 59 of this proxy statement/prospectus), litigation payment principal reduction (see discussion beginning on page 61 of this proxy statement/prospectus) and indemnification provisions (see discussion beginning on page 57 of this proxy statement/prospectus) of the merger agreement or in the event that the expenses of the payment agent and the indenture trustee exceed $80,000. Management of MedSolutions does not believe that there will be any meaningful adjustment to the merger consideration.
     Treatment of MedSolutions Stock Options (page 55)
     All MedSolutions stock options have vested. At the effective time of the merger, the MedSolutions stock options will be canceled and converted to a right to receive the merger consideration for each deemed outstanding MedSolutions option share. The number of deemed outstanding MedSolutions option shares attributable to each MedSolutions stock option will be equal to the net number of shares of MedSolutions common stock (rounded down to the next whole share) that would have been issued upon a cashless exercise of that MedSolutions stock option immediately before the effective time of the merger. That net number of shares will be computed by deducting from the shares of MedSolutions common stock that would be issued to the option holder a number of deemed surrendered shares of MedSolutions common stock which is equal to the fair value of (i) the exercise price of a MedSolutions stock option to be paid by the option holder and (ii) all amounts required to be withheld and paid by MedSolutions for federal taxes and other payroll withholding obligations as a result of such exercise (using an assumed tax rate of 35%). The fair value of each deemed surrendered share of MedSolutions common stock, for purposes of determining the net number of shares, will be equal to $2.00.
Material United States Federal Income Tax Consequences of the Merger to MedSolutions Shareholders (page 51)
     For a discussion of the United States federal income tax consequences of the merger, see “Material United States Federal Income Tax Consequences” beginning on page 51 of this proxy statement prospectus). Note in particular that the merger is structured as a taxable transaction for United States federal income tax purposes and may result in a taxable transaction under applicable state, local and other income tax laws. Assuming the Medsolutions shares have been held as a capital asset, the gain or loss recognized by a Medsolutions shareholder exchanging Medsolutions shares for merger consideration would generally be treated as capital gain or loss, subject to the limitations and further discussion set forth in “Material United States Federal Income Tax Consequences.” As further discussed therein, installment sale treatment may be available. Backup withholding may apply in the event requisite documentation of identity (on a substitute Form W9) is not provided.
     Tax matters can be complicated and the tax consequences of the merger to MedSolutions shareholders will depend on each shareholder's particular tax situation. You should consult your tax advisors to understand fully the tax consequences of the merger to you. Statements in this proxy statement/prospectus of the tax consequences or tax risks of the merger to U.S. holders of MedSolutions common stock are not intended nor written to be used, and cannot be used, by any person for the purpose of avoiding tax penalties that may be imposed on such person. Such statements were prepared to support the marketing of the transaction(s) or matter(s) addressed by such written discussion, and the taxpayer should seek advice based on the taxpayer’s particular circumstances from an independent tax advisor.
MedSolutions’ Board of Directors’ Recommendation to Shareholders (page 35)
     The MedSolutions Board of Directors has unanimously determined that the merger is advisable and in your best interests and unanimously recommends that you vote FOR the approval and adoption of the merger agreement and any adjournment or postponement of the special meeting. The merger has many advantages for MedSolutions shareholders and no significant disadvantages. By allowing MedSolutions shareholders to liquidate their investment in MedSolutions, management of MedSolutions believes they will have better investment opportunities than retaining their interests in MedSolutions. To be sure, MedSolutions shareholders can find much less risky investments with equal or better profit potential than if MedSolutions remained an independent company and its shareholders maintained their ownership in MedSolutions. The only disadvantage of the merger is that MedSolutions shareholders may find it difficult to invest in another company in MedSolutions’ industry other than Stericycle.
Opinion of MedSolutions’ Valuation Advisor (page 41)
     In connection with the proposed merger, MedSolutions’ valuation advisor, Van Amburgh Valuation Associates, Inc. (“Van Amburgh”), delivered to MedSolutions’ Board of Directors a written opinion, dated June 30, 2007, as to the fairness, from a financial point of view, to the holders of MedSolutions common stock of the merger consideration. Van Amburgh’s opinion concluded that the merger is fair, from a financial point of view, to MedSolutions’ shareholders. The full text of Van Amburgh’s written opinion is attached to this proxy statement/prospectus as Annex C. We encourage you to read that opinion carefully in its entirety for a description of the procedures followed, assumptions made, matters considered and limitations on the review undertaken by Van Amburgh in rendering its opinion. Van Amburgh’s opinion was provided to MedSolutions’ Board of Directors in connection with its evaluation of the merger and does not constitute a recommendation to any shareholder as to how he, she or it should vote on the merger or any matter relevant to the merger agreement.

10


Table of Contents

Stericycle’s Reasons for the Merger (page 11)
     Stericycle anticipates that the acquisition of MedSolutions will increase Stericycle’s revenues and improve its operating profits through the integration of MedSolutions’ operations with those of Stericycle. The addition of MedSolutions’ customers will improve route densities, and the addition of MedSolutions’ facilities will shorten travel distances, thereby reducing overall transportation costs. Stericycle also anticipates a reduction in overhead costs as a result of the integration.
     These anticipated benefits depend on several factors and on other uncertainties. See “Risk Factors” beginning on page 16.
Board of Directors and Executive Officers of Stericycle and the Surviving Corporation Following the Merger (page 57)
     Stericycle’s directors and executive officers will not change by reason of the merger. The officers and directors of Merger Sub immediately prior to the effective time will become the directors and officers of the surviving corporation following the merger.
Interests of Certain MedSolutions Officers and Directors in the Merger (page 49)
     When you consider the MedSolutions Board of Director’s recommendation that MedSolutions shareholders vote in favor of the merger agreement and any adjournment or postponement of the special meeting, you should be aware that some MedSolutions officers and directors may have interests in the merger that may be different from, or in addition to, the interests of other MedSolutions shareholders generally. For instance, several of MedSolutions’ directors have made loans to MedSolutions which will be repaid in full as a result of the merger. Mr. Fleeger, MedSolutions’ President and Chief Executive Officer and a director, will be retained for six months as a consultant to Stericycle at the same rate of pay as his current employment agreement with MedSolutions. Finally, the directors and executive officers of MedSolutions are required to execute a noncompetition agreement with Stericycle. The MedSolutions Board of Directors was aware of these interests and considered them, among other matters, in unanimously approving and adopting the merger agreement and unanimously recommending that MedSolutions shareholders vote to approve and adopt the merger agreement. In addition, two non-officer directors who were disinterested directors, namely Mr. David Mack and Mr. Steven Block, voted to approve the merger. At the close of business on the record date for the MedSolutions special meeting, directors and executive officers of MedSolutions and their affiliates beneficially owned approximately 13.6% of the shares of MedSolutions common stock outstanding on that date.

11


Table of Contents

Conditions to Completion of the Merger (page 66)
     Completion of the merger depends on a number of conditions being satisfied or waived. These conditions include the following:
    adoption of the merger agreement by the holders of at least a majority of the outstanding MedSolutions shares entitled to vote at the MedSolutions special meeting;
 
    continued effectiveness of the registration statement of which this proxy statement/prospectus is a part, the absence of a stop order by the Securities and Exchange Commission suspending the effectiveness of the registration statement and the absence of any continuing action, suit, proceeding or investigation by the SEC to suspend such effectiveness;
 
    absence of any temporary restraining order, preliminary or permanent injunction or other order issued by a court or other governmental authority making the merger illegal or otherwise prohibiting the consummation of the merger;
 
    absence of MedSolutions shareholders exercising their appraisal and dissenters rights with respect to greater than 7.5% of the outstanding shares of MedSolutions common stock immediately prior to the effective time of the merger;
 
    entry by Stericycle into consulting agreements and/or noncompetition agreements with certain of the officers, directors, employees and shareholders of MedSolutions;
 
    accuracy as of the closing of the merger of the representations and warranties made by each of MedSolutions, Stericycle and Merger Sub to the extent specified in the merger agreement; and
 
    MedSolutions’, Stericycle’s and Merger Sub’s performance in all material respects of their respective obligations, agreements and conditions under the merger agreement.
Termination of the Merger Agreement (page 67)
     Before the effective time of the merger, the merger agreement may be terminated:

12


Table of Contents

  by mutual written consent of Stericycle, Merger Sub and MedSolutions;
 
  by either Stericycle or MedSolutions, if:
    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained;
 
    the parties fail to consummate the merger on or before November 30, 2007, unless the failure is the result of a breach of the merger agreement by the party seeking the termination; or
 
    any governmental authority has issued a final and nonappealable order, decree or ruling or has taken any other final and nonappealable action that restrains, enjoins or otherwise prohibits the merger, unless the party seeking the termination has not used its reasonable best efforts to oppose such order or decision or to have such order or decision vacated or made inapplicable to the merger;
  by Stericycle, if:
    MedSolutions materially breaches any of its representations, warranties, covenants or agreements set forth in the merger agreement, and MedSolutions has not cured such breach within 15 business days of receiving written notice from Stericycle of such breach;
 
    one or more of Stericycle’s conditions precedent to closing the merger are not satisfied or capable of being satisfied on or before November 30, 2007 as a result of MedSolutions’ failure to comply with its obligations under the merger agreement;
 
    MedSolutions’ Board of Directors withdraws or materially and adversely to Stericycle modifies its approval of the merger agreement and the merger, other than (i) as a result of a material breach by Stericycle or Merger Sub of a representation, warranty or covenant under the merger agreement which remains uncured for a period of two business days after receipt of notice from MedSolutions of such breach, or (ii) as a result of the failure of any of MedSolutions’ conditions precedent to closing the merger not being met; or
 
    MedSolutions enters into a definitive agreement (other than the merger agreement) to implement:
    an investment in MedSolutions representing (on a post-investment basis) more than 25% of MedSolutions’ capital stock or a purchase from MedSolutions of more than 25% of the shares of its capital stock or any debt securities convertible into or exchangeable for more than 25% of the shares of its capital stock;
 
    a merger, consolidation, share exchange, recapitalization, business combination or other similar transaction involving all of MedSolutions’ equity interests or all shares of the MedSolutions common stock;
 
    the sale, lease, exchange, mortgage, pledge, transfer or other disposition of all or substantially all of MedSolutions’ assets in a single transaction or a series of related transactions;
 
    a tender offer or exchange offer for 25% or more of the outstanding shares of MedSolutions’ capital stock or the filing of a registration statement under the Securities Act of 1933, as amended, in connection with such a tender offer or exchange offer; or
 
    any public announcement of a proposal, plan or intention to do so, or any agreement to engage in, any of the matters described immediately above;

13


Table of Contents

    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained by reason of the violation of the voting agreement by one or more of MedSolutions’ shareholders who are party to the voting agreement;
    by MedSolutions, if:
    either Stericycle or Merger Sub materially breaches any of its representations, warranties, covenants or agreements set forth in the merger agreement, and Stericycle or Merger Sub, as the case may be, has not cured such breach within 15 business days of receiving written notice from MedSolutions of such breach;
 
    one or more of MedSolutions’ conditions precedent to closing the merger are not satisfied or capable of being satisfied on or before November 30, 2007 as a result of either Stericycle’s or Merger Sub’s failure to comply with its obligations under the merger agreement; or
 
    MedSolutions enters into a definitive agreement providing for the implementation of a superior proposal, which is defined as the acquisition by a third party of more than 50% of the voting power of MedSolutions’ equity securities or more than 50% of MedSolutions’ assets, pursuant to a tender or exchange offer, merger, consolidation, liquidation or dissolution, recapitalization, sale of assets or otherwise, if MedSolutions’ Board of Directors has determined in its good faith judgment, after consultation with MedSolutions’ valuation advisor and after considering the likelihood and timing of the consummation of such third party transaction and any amendments or modifications to the merger agreement that Stericycle has offered or proposed within five days of learning of such proposed transaction, that such transaction is more favorable from a financial point of view to MedSolutions’ shareholders than the merger with Stericycle.
     If the merger agreement is validly terminated, the merger agreement will become void without any liability on the part of any party unless that party is in breach. However, certain provisions of the merger agreement, including, among others, those provisions relating to expenses and termination fees, will continue in effect notwithstanding termination of the merger agreement.
Fees and Expenses (page 69)
     MedSolutions must pay to Stericycle a termination fee of $2,500,000 in the following circumstances:
    if MedSolutions terminates the merger agreement because MedSolutions enters into a definitive agreement providing for the implementation of a superior proposal, which is defined as the acquisition by a third party of more than 50% of the voting power of MedSolutions’ equity securities or more than 50% of MedSolutions’ assets, pursuant to a tender or exchange offer, merger, consolidation, liquidation or dissolution, recapitalization, sale of assets or otherwise, if MedSolutions’ Board of Directors has determined in its good faith judgment, after consultation with MedSolutions’ valuation advisor and after considering the likelihood and timing of the consummation of such third party transaction and any amendments or modifications to the merger agreement that Stericycle has offered or proposed within five days of learning of such proposed transaction, that such transaction is more favorable from a financial point of view to MedSolutions’ shareholders than the merger with Stericycle; or
 
    if Stericycle terminates the merger agreement because:
    MedSolutions’ Board of Directors withdraws or materially and adversely to Stericycle modifies its approval of the merger agreement and the merger, other than (i) as a result of a material breach by Stericycle or Merger Sub of a representation, warranty or covenant under

14


Table of Contents

      the merger agreement which remains uncured for a period of two business days after receipt of notice from MedSolutions of such breach, or (ii) as a result of the failure of any of MedSolutions’ conditions precedent to closing the merger not being met;
 
    MedSolutions enters into a definitive agreement (other than the merger agreement) to implement:
    an investment in MedSolutions representing (on a post-investment basis) more than 25% of MedSolutions’ capital stock or a purchase from MedSolutions of more than 25% of the shares of its capital stock or any debt securities convertible into or exchangeable for more than 25% of the shares of its capital stock;
 
    a merger, consolidation, share exchange, recapitalization, business combination or other similar transaction involving all of MedSolutions’ equity interests or all shares of the MedSolutions common stock;
 
    the sale, lease, exchange, mortgage, pledge, transfer or other disposition of all or substantially all of MedSolutions’ assets in a single transaction or a series of related transactions;
 
    a tender offer or exchange offer for 25% or more of the outstanding shares of MedSolutions’ capital stock or the filing of a registration statement under the Securities Act of 1933, as amended, in connection with such a tender offer or exchange offer; or
 
    any public announcement of a proposal, plan or intention to do so, or any agreement to engage in, any of the matters described immediately above; or
    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained by reason of the violation of the voting agreement by one or more of MedSolutions’ shareholders who are party to the voting agreement.
In general, each of Stericycle, Merger Sub and MedSolutions will bear its own expenses in connection with the merger agreement and the related transactions. If the merger is consummated, the surviving corporation to the merger will pay MedSolutions’ transaction expenses up to $100,000. If the merger is not consummated, all expenses incurred in connection with the merger agreement and the related transactions will be paid by the party incurring them. If the merger is consummated, Stericycle will pay the fees and expenses of the payment agent selected to distribute the merger consideration and the fees and expenses of the indenture trustee in respect of the promissory notes, up to $80,000 in the aggregate. Any reasonable fees and expenses of the payment agent and indenture trustee in excess of $80,000 in the aggregate will be paid by Stericycle and reimbursed by reducing the principal amount of the promissory notes by the amount of such expenses.
No Solicitation by MedSolutions (page 64)
The merger agreement restricts the ability of MedSolutions to solicit or engage in discussions or negotiations with a third party regarding a proposal to merge with or acquire a significant interest in MedSolutions. However, if MedSolutions receives an acquisition proposal from a third party that is more favorable to MedSolutions shareholders than the terms of the merger agreement and MedSolutions complies with specified procedures contained in the merger agreement, MedSolutions may furnish nonpublic information to that third party and engage in negotiations regarding an acquisition proposal with that third party, subject to specified conditions.
Accounting Treatment (page 45)
Stericycle will account for the merger using the purchase method of accounting.

15


Table of Contents

RISK FACTORS
     In addition to the other information included and incorporated by reference into this proxy statement/prospectus, including the matters addressed under the caption “Cautionary Statement Regarding Forward-Looking Statements” beginning on page 26, you should carefully read and consider the following risk factors in evaluating the proposals to be voted on at the special meeting of MedSolutions shareholders and in determining whether to vote for approval and adoption of the merger agreement. Please also refer to the additional risk factors identified in the periodic reports and other documents incorporated by reference into this proxy statement/prospectus and see “Where You Can Find More Information” beginning on page 215.
Risks Relating to the Merger
The merger is subject to certain conditions to closing that, if not satisfied or waived, will result in the merger not being completed.
     The merger is subject to customary conditions to closing, as set forth in the merger agreement. The conditions to the merger include, among others, the receipt of the required approval of MedSolutions’ shareholders. If any of the conditions to the merger are not satisfied or, if waiver is permissible, not waived, the merger will not be completed. In addition, under circumstances specified in the merger agreement, Stericycle or MedSolutions may terminate the merger agreement. As a result, we cannot assure you that we will complete the merger. See “The Merger Agreement — Conditions Precedent” beginning on page 66 for a discussion of the conditions to the completion of the merger.
Certain directors and executive officers of MedSolutions have interests and arrangements that are different from, or in addition to, those of MedSolutions’ shareholders and that may influence or have influenced their decision to support or approve the merger.
     When considering the recommendation of MedSolutions’ Board of Directors with respect to the merger, holders of MedSolutions common stock should be aware that certain of MedSolutions’ directors and executive officers have interests in the merger that are different from, or in addition to, their interests as MedSolutions shareholders and the interests of MedSolutions shareholders generally. These interests include, among other things, the following:
    One or more officers of MedSolutions will enter into consulting agreements with Stericycle upon effectiveness of the merger;
 
    pursuant to the merger agreement, all employment agreements entered into between MedSolutions and its officers will be terminated at or prior to closing, and such officers will be paid all severance benefits payable in connection with such terminations;
 
    the merger agreement provides for the cashless exercise of all MedSolutions stock options held by directors and officers as of the effective time of the merger;
 
    all debt owed by MedSolutions to its officers and directors will be paid in full within 30 days of the effective time of the merger; and
 
    certain officers and directors of MedSolutions will be indemnified by Stericycle as of the effective time of the merger and released from their personal guarantees of MedSolutions debt no later than 30 days after the effective time.

16


Table of Contents

     As a result, these directors and executive officers may be more likely to support and to vote to approve the merger than if they did not have these interests. Holders of MedSolutions common stock should consider whether these interests may have influenced these directors and officers to support or recommend approval of the merger. As of the close of business on the record date for the MedSolutions special meeting, these directors and executive officers and their affiliates beneficially owned approximately 13.6% of the shares of MedSolutions common stock outstanding on that date. These and additional interests of certain directors and executive officers of MedSolutions are more fully described in the sections entitled “Interests of MedSolutions Directors and Executive Officers in the Merger” beginning on page 49 of this proxy statement/prospectus.
We may face difficulties in achieving the expected benefits of the merger.
     Stericycle and MedSolutions currently operate as separate companies. Stericycle’s management has no experience running the combined business, and Stericycle may not be able to realize the operating efficiencies, synergies, cost savings or other benefits expected from the merger. In addition, the costs Stericycle incurs in implementing synergies, including its ability to amend, renegotiate or terminate prior contractual commitments of MedSolutions, may be greater than expected. Stericycle also may suffer a loss of customers or suppliers, a loss of revenues, or an increase in operating or other costs or other difficulties relating to the merger.
MedSolutions will be subject to business uncertainties and contractual restrictions while the merger is pending.
     Uncertainty about the effect of the merger on employees, suppliers, partners, regulators and customers may have an adverse effect on MedSolutions and potentially on Stericycle. These uncertainties may impair MedSolutions’ ability to attract, retain and motivate key personnel until the merger is consummated, and could cause suppliers, customers and others that deal with MedSolutions to defer purchases or other decisions concerning MedSolutions, or to seek to change existing business relationships with MedSolutions. Employee retention may be particularly challenging during the pendency of the merger, as employees may experience uncertainty about their future roles with Stericycle. If key employees depart because of issues relating to the uncertainty and difficulty of integration or a desire not to remain with Stericycle, Stericycle’s business following the merger could be harmed. In addition, the merger agreement restricts MedSolutions from making certain acquisitions and taking other specified actions until the merger occurs. These restrictions may prevent MedSolutions from pursuing attractive business opportunities that may arise prior to the completion of the merger. See “The Merger Agreement — Covenants and Agreements” beginning on page 63 for a description of the restrictive covenants applicable to MedSolutions.
The merger agreement limits MedSolutions’ ability to pursue alternatives to the merger.
     The merger agreement contains provisions that could adversely impact competing proposals to acquire MedSolutions. These provisions include the prohibition on MedSolutions generally from soliciting any acquisition proposal or offer for a competing transaction and the requirement that MedSolutions pay to Stericycle $2.5 million if the merger agreement is terminated in specified circumstances in connection with an alternative transaction. In addition, even if the Board of Directors of MedSolutions determines that a competing proposal to acquire MedSolutions is superior, MedSolutions may not exercise its right to terminate the merger agreement unless it notifies Stericycle of its intention to do so and gives Stericycle at least five days to propose revisions to the terms of the merger agreement or to make another proposal in response to the competing proposal. See “The Merger Agreement — Covenants and Agreements” beginning on page 63 and “The Merger Agreement — Termination” beginning on page 67.

17


Table of Contents

     Stericycle required MedSolutions to agree to these provisions as a condition to Stericycle’s willingness to enter into the merger agreement. These provisions, however, might discourage a third party that might have an interest in acquiring all or a significant part of MedSolutions from considering or proposing that acquisition, even if that party were prepared to pay consideration with a higher value than the current proposed merger consideration. Furthermore, the termination fee may result in a potential competing acquirer proposing to pay a lower per share price to acquire MedSolutions than it might otherwise have proposed to pay.
Failure to complete the merger could negatively impact the stock value and the future business and financial results of MedSolutions.
     Although MedSolutions has agreed that its Board of Directors will, subject to fiduciary exceptions, recommend that its shareholders approve and adopt the merger agreement, there is no assurance that the merger agreement and the merger will be approved, and there is no assurance that the other conditions to the completion of the merger will be satisfied. If the merger is not completed, MedSolutions will be subject to several risks, including the following:
    MedSolutions may be required to pay Stericycle $2.5 million if the merger agreement is terminated under certain circumstances and MedSolutions enters into or completes an alternative transaction;
 
    Certain costs relating to the merger (such as legal, accounting and valuation advisory fees) are payable by MedSolutions whether or not the merger is completed;
 
    There may be substantial disruption to the business of MedSolutions and a distraction of its management and employees from day-to-day operations, because matters related to the merger may require substantial commitments of time and resources, which could otherwise have been devoted to other opportunities that could have been beneficial to MedSolutions;
 
    MedSolutions’ business could be adversely affected if it is unable to retain key employees or attract qualified replacements; and
 
    MedSolutions would continue to face the risks that it currently faces, as described below in the section entitled “Information About MedSolutions” beginning on page 78 of this proxy statement/prospectus.
     In addition, MedSolutions would not realize any of the expected benefits of having completed the merger. If the merger is not completed, these risks may materialize and materially adversely affect MedSolutions’ business, financial results, financial condition and stock value.
The opinion obtained by MedSolutions from its valuation advisor does not reflect changes in circumstances between signing the merger agreement and the completion of the merger.
     Van Amburgh, MedSolutions’ valuation advisor, delivered a “fairness opinion” to the MedSolutions Board of Directors. The opinion states that, as of June 30, 2007, the consideration to be received by MedSolutions shareholders pursuant to the merger agreement was fair from a financial point of view to MedSolutions shareholders. The opinion does not reflect changes that may have occurred after March 31, 2007, including changes to the operations and prospects of MedSolutions and Stericycle, changes in general market and economic conditions, or other factors; however, the opinion did take into account the potentially adverse effect of the verdict rendered against EMSI as described in the section entitled “The Merger Agreement—Adjustments to Merger Consideration—Litigation Adjustment” on page 61 of this proxy statement/prospectus. Any such changes, or other factors on which the opinion is based, may significantly alter the value of MedSolutions or Stericycle by the time the merger is completed. The opinion does not speak as of the time the merger will be completed or as of any date other than the date of such opinion. For a description of the opinion that MedSolutions received

18


Table of Contents

from its valuation advisor, see “The Merger — Opinion of MedSolutions’ Valuation Advisor” beginning on page 41. For a description of the other factors considered by MedSolutions’ Board of Directors in determining to approve the merger, see “The Merger — MedSolutions’ Reasons for the Merger” beginning on page 39 and “The Merger — Recommendation of the MedSolutions Board of Directors” beginning on page 40.
Risks Relating to the Promissory Notes
The promissory notes are not secured obligations of Stericycle. The 3.5% notes are supported by a letter of credit, however.
     The promissory notes are not secured by any assets of Stericycle and thus are general unsecured obligations. They do not have priority over any of Stericycle’s other indebtedness, and in the event of any bankruptcy proceedings, holders of the promissory notes would be in the same position as all of Stericycle’s other unsecured creditors. As of June 30, 2007, Stericycle’s long-term indebtedness, net of the current portion, was $508.7 million. None of Stericycle’s debt is senior to the promissory notes.
     Stericycle’s obligations under the 3.5% notes are supported by a letter of credit to the indenture trustee. In the event of any default by Stericycle in payment of the 3.5% notes, the indenture trustee, either on the trustee’s own initiative or at the direction of the shareholder representative, may declare all of the indebtedness represented by the 3.5% notes to be due and draw on the letter of credit for full payment of the amount owed. Accordingly, payment of the 3.5% notes is not ultimately dependent on Stericycle’s ability to make the payments due on the promissory notes.
Stericycle may not be able to generate sufficient cash to make the payments due on the promissory notes and its other indebtedness.
     Stericycle’s ability to make the payments due on the promissory notes depends on its financial and operating performance, which is subject to prevailing economic and competitive conditions and certain financial, business and other factors beyond Stericycle’s control. Stericycle cannot assure you that its cash flows from operations and other sources of liquidity will be sufficient to permit it to make the payments due on the promissory notes and the payments due on its other indebtedness.
Stericycle may incur substantial additional debt, which could increase its difficulty in making the payments due on the promissory notes.
     The promissory notes and the indentures under which they will be issued do not contain any restrictions preventing Stericycle from incurring additional debt. To the extent that Stericycle does so, Stericycle may find it more difficult, and may be unable, to make the payments due on the promissory notes and the payments due on its other indebtedness.
You may find it difficult to sell your promissory notes, on favorable terms or at all.
     There will be no public market for the promissory notes, and thus you may be unable to sell your promissory notes.
     If you are able to sell your promissory notes in a privately negotiated transaction, the purchaser may be expected to require a discount from the face amount of the promissory notes. This discount is likely to be very substantial because of:
    the interest rate on the promissory notes, which may be less than prevailing market rates;

19


Table of Contents

    the maturity date of the promissory notes, which is not for seven years after the closing of the merger;
 
    the potential reduction in the principal of the promissory notes, in one case retroactive to the date of issuance, by reason of a merger consideration principal reduction or litigation payment principal reduction; or
 
    the potential reduction in the interest payments on the promissory notes (and possibly even the principal of the promissory notes), by reason of an indemnification claim payment reduction.
See “Merger Agreement—Adjustments to Merger Consideration” beginning on page 59 of this proxy statement/prospectus.
Payments under the promissory notes are subject to reduction
     Payments under the promissory notes are subject to reduction by reason of an indemnification claim payment reduction. This reduction is in the nature of a dollar-for-dollar offset. See “The Merger Agreement—Representations and Warranties and Indemnification” on page 57 of this proxy statement/prospectus.
The principal amount of the promissory notes is subject to reduction
     The principal amount of the promissory notes is subject to reduction, retroactive to the date of issuance of the promissory notes, by reason of a merger consideration principal reduction. The principal amount of the promissory notes is also subject to reduction, effective as of the date of payment, by reason of a litigation payment principal reduction and by an expense payment principal reduction.
     Closing Balance Sheet Adjustment. The aggregate principal amount of the promissory notes will be reduced on a dollar-for-dollar basis to the extent that MedSolutions’ adjusted liabilities exceed its adjusted current assets as of the closing date of the merger by more than $4,340,000. For example, if MedSolutions’ adjusted liabilities exceed its adjusted current assets by $4,500,000 as of the closing date, $160,000 would be offset from the aggregate principal amount of the promissory notes. To the extent that the difference between MedSolutions’ adjusted liabilities and its adjusted current assets is determined to be less than $4,340,000 as of the closing date, the amount by which such difference is less than $4,340,000 will either be used to reduce any offset on account of the revenue adjustment described below or deposited with the payment agent within three days of the date of such determination for distribution to the MedSolutions’ shareholders as additional cash merger consideration.
      Revenue Adjustment. The aggregate principal amount of the promissory notes will be reduced to the extent that MedSolutions’ measured revenues, which include the annualized gross revenues received by the surviving corporation during the first three full calendar months after the closing from certain of MedSolutions’ existing customers, are less than $16,000,000. To the extent that such measured revenues are less than $16,000,000, the aggregate principal amount of the notes will be reduced (subject to any credit on account of the closing balance sheet adjustment described above) by an amount equal to the product of (i) the difference between $16,000,000 and the amount of measured revenues multiplied by (ii) 3.375. For example, if the measured revenues are $15,900,000, $337,500 would be offset from the aggregate principal amount of the promissory notes. The merger agreement stipulates that MedSolutions has already achieved $15,655,352 in annualized gross revenues for purposes of the revenue adjustment. Accordingly, the maximum amount by which the aggregate principal amount of the promissory notes could be reduced on account of the revenue adjustment is $1,163,187.
      Litigation Payment and Expense Payment Adjustments. The aggregate principal amount of the promissory notes will be reduced effective as of the date on which the final payments of principal and interests are due to MedSolutions’ shareholders (the seventh anniversary of the date of the merger) by an amount equal to the difference between $250,000 and the amount remaining in the shareholder representative escrow account on such date. The aggregate principal amount of the promissory notes will also be reduced in the event that the expenses of the payment agent and the indenture trustee exceed $80,000.
     See “The Merger Agreement—Adjustments to Merger Consideration,” “The Merger Agreement — Payment Procedures,” “— Adjustments to Merger Consideration—Application of Closing Balance Sheet and Revenue Adjustments” and “ — Litigation Adjustment” on pages 59, 56, 60 and 61 of this proxy statement/prospectus.

20


Table of Contents

Risks Relating to MedSolutions in the Event the Merger Does Not Occur
MedSolutions has historically had a history of losses.
     MedSolutions’ expenses have historically exceeded its revenues and MedSolutions has had losses in all previous fiscal years of operation except for 2005. MedSolutions has been a developing company concentrating on the development of its products and business plan. In the event that the merger does not occur, MedSolutions’ management believes that MedSolutions can be profitable and that its business plan will be successful; however, there is no assurance that MedSolutions will be successful in implementing its business plan or that it will be profitable now or in the future.
Future governmental actions, including the issuance of new regulations, could significantly affect MedSolutions’ business.
     Governmental authorities may take future actions that could pose obstacles in the waste disposal industry and require methods or technology different from the methods currently developed or utilized by MedSolutions. MedSolutions is not able to predict the outcome of any such actions, controls, regulations or laws on its operations and any significant reduction in revenues due to such changes could result in operating income becoming insufficient to cover operating expenses.
MedSolutions faces significant competition in its industry.
     The medical/special waste disposal, document destruction, reusable sharps management and OSHA compliance services industries are extremely competitive. MedSolutions competes with a number of competitors offering similar technologies or services for the treatment of medical waste as well as those using similar or dissimilar technologies or products. Some of these competitors have significantly greater financial, advertising and marketing resources than MedSolutions.
The development of new technologies may make MedSolutions’ current waste treatment technologies obsolescent.
     Development of new, improved waste destruction devices or methods may make MedSolutions’ devices and/or methods obsolete, less competitive or require substantial capital outlays by MedSolutions to purchase or license such new technologies, if available.
MedSolutions’ business is subject to significant uninsured business and environmental risks.
     MedSolutions’ business plan is to engage in business opportunities that involve the handling of infectious medical and related waste. As insurance is available and within the financial means of MedSolutions, MedSolutions intends to insure itself from risks related to its business. However, if insurance is not available, is available and beyond the financial means of MedSolutions, or insurance is purchased but loss limits are not adequate to cover all liabilities, then MedSolutions would not be financially capable of paying a substantial judgment or claim against MedSolutions, thereby placing MedSolutions in a financially adverse position or forcing its closure.
MedSolutions’ business is dependent upon the effectiveness of governmental permits.
     MedSolutions is subject to extensive and frequently changing federal, state and local laws and regulations. This statutory and regulatory framework imposes compliance burdens and risks on MedSolutions, including requirements to obtain and maintain government permits. These permits grant MedSolutions the authority, among other things, to construct and operate treatment and transfer facilities, transport medical waste within and between relevant jurisdictions, and to handle particular regulated substances. MedSolutions’ permits must be periodically renewed and are subject to modification or revocation by the regulatory authorities. The loss of any of these permits could have a material adverse effect on MedSolutions’ operations.
If MedSolutions continues to generate negative operating cash flows and is unable to secure adequate funding sources, it may be unable to meet its long-term liquidity needs in the future.
     MedSolutions’ working capital deficit at June 30, 2007 was $1,527,059, and MedSolutions did not generate positive operating cash flows during the six months ended June 30, 2007. While MedSolutions anticipates that its operating cash flow will increase over the next 12 months, such additional operating cash flow may not be sufficient, by itself, to meet MedSolutions’ long-term liquidity needs. MedSolutions has historically funded its long-term liquidity needs through the sale of equity securities and by obtaining loans from shareholders as well as traditional bank financing. In March 2007, MedSolutions obtained a $1,500,000 working capital line of credit that it expects will satisfy its short-term liquidity needs. However, in the event that MedSolutions continues to generate negative operating cash flows in the future and is unable to secure adequate additional debt or equity financing, MedSolutions may be unable to meet its long-term debt and other obligations in the future.

21


Table of Contents

Risks Relating to Stericycle
Stericycle is subject to extensive governmental regulation, which is frequently difficult, expensive and time-consuming to comply with.
     The regulated waste management industry is subject to extensive federal, state and local laws and regulations relating to the collection, transportation, packaging, labeling, handling, documentation, reporting, treatment and disposal of regulated waste. Stericycle’s business requires it to obtain many permits, authorizations, approvals, certificates or other types of governmental permission from every jurisdiction where it operates. Stericycle believes that it currently complies in all material respects with all applicable permitting requirements. State and local regulations change often, however, and new regulations are frequently adopted. Changes in the regulations could require Stericycle to obtain new permits or to change the way in which it operates under existing permits. Stericycle might be unable to obtain the new permits that it requires, and the cost of compliance with new or changed regulations could be significant.
     Many of the permits that Stericycle requires, especially those to build and operate processing plants and transfer facilities, are difficult and time-consuming to obtain. They may also contain conditions or restrictions that limit Stericycle’s ability to operate efficiently, and they may not be issued as quickly as Stericycle needs them (or at all). If Stericycle cannot obtain the permits that it needs when it needs them, or if they contain unfavorable conditions, it could substantially impair Stericycle’s operations and reduce its revenues.
The handling and treatment of regulated waste carries with it the risk of personal injury to employees and others.
     Stericycle’s business requires it to handle materials that may be infectious or hazardous to life and property. While Stericycle tries to handle such materials with care and in accordance with accepted and safe methods, the possibility of accidents, leaks, spills, and acts of God always exists. Examples of possible exposure to such materials include:
    truck accidents;
 
    damaged or leaking containers;
 
    improper storage of regulated waste by customers;
 
    improper placement by customers of materials into the waste stream that Stericycle is not authorized or able to process, such as certain body parts and tissues; or
 
    malfunctioning treatment plant equipment.
     Human beings, animals or property could be injured, sickened or damaged by exposure to regulated waste. This in turn could result in lawsuits in which Stericycle is found liable for such injuries, and substantial damages could be awarded against Stericycle.
     While Stericycle carries liability insurance intended to cover these contingencies, particular instances may occur that are not insured against or that are inadequately insured against. An uninsured or underinsured loss could be substantial and could impair Stericycle’s profitability and reduce Stericycle’s liquidity.

22


Table of Contents

The handling of regulated waste exposes Stericycle to the risk of environmental liabilities, which may not be covered by insurance.
     As a company engaged in regulated waste management, Stericycle faces risks of liability for environmental contamination. The federal Comprehensive Environmental Response, Compensation and Liability Act of 1980, or CERCLA, and similar state laws impose strict liability on current or former owners and operators of facilities that release hazardous substances into the environment as well as on the businesses that generate those substances and the businesses that transport them to the facilities. Responsible parties may be liable for substantial investigation and clean-up costs even if they operated their businesses properly and complied with applicable federal and state laws and regulations. Liability under CERCLA may be joint and several, which means that if Stericycle were found to be a business with responsibility for a particular CERCLA site, Stericycle could be required to pay the entire cost of the investigation and clean-up even though Stericycle was not the party responsible for the release of the hazardous substance and even though other companies might also be liable.
     Stericycle’s pollution liability insurance excludes liabilities under CERCLA. Thus, if Stericycle were to incur liability under CERCLA and if it could not identify other parties responsible under the law whom it is able to compel to contribute to its expenses, the cost to Stericycle could be substantial and could impair its profitability and reduce its liquidity. Stericycle’s customer service agreements make clear that the customer is responsible for making sure that only appropriate materials are disposed of. However, if there were a claim against Stericycle that a customer might be legally liable for, Stericycle might not be successful in recovering our damages from the customer.
The level of governmental enforcement of environmental regulations has an uncertain effect on Stericycle’s business and could reduce the demand for its services.
     Stericycle believes that the government’s strict enforcement of laws and regulations relating to regulated waste collection and treatment has been good for its business. These laws and regulations increase the demand for Stericycle’s services. A relaxation of standards or other changes in governmental regulation of regulated waste could increase the number of competitors or reduce the need for Stericycle’s services.
If Stericycle is unable to acquire other regulated waste businesses, its revenue and profit growth may be slowed.
     Historically Stericycle’s growth strategy has been based in substantial part on its ability to acquire other regulated waste businesses. Stericycle does not know whether in the future it will be able to:
    identify suitable businesses to buy;
 
    complete the purchase of those businesses on terms acceptable to Stericycle;
 
    improve the operations of the businesses that Stericycle does buy and successfully integrate their operations into Stericycle’s; or
 
    avoid or overcome any concerns expressed by regulators.
     Stericycle competes with other potential buyers for the acquisition of other regulated waste companies. This competition may result in fewer opportunities to purchase companies that are for sale. It may also result in higher purchase prices for the businesses that Stericycle wants to purchase.
     Stericycle also does not know whether its growth strategy will continue to be effective. Stericycle’s business is significantly larger than before, and new acquisitions may not have the desired benefits that it has obtained in the past.

23


Table of Contents

The implementation of Stericycle’s acquisition strategy could be affected in certain instances by the concerns of state regulators, which could result in Stericycle’s not being able to realize the full synergies or profitability of particular acquisitions.
     Stericycle may become subject to inquiries and investigations by state antitrust regulators from time to time in the course of completing acquisitions of other regulated waste businesses. In order to obtain regulatory clearance for a particular acquisition, Stericycle could be required to modify certain operating practices of the acquired business or to divest itself of one or more assets of the acquired business. Changes in the terms of Stericycle’s acquisitions required by regulators or agreed to by Stericycle in order to settle regulatory investigations could impede its acquisition strategy or reduce the anticipated synergies or profitability of its acquisitions. The likelihood and outcome of inquiries and investigations from state regulators in the course of completing acquisitions cannot be predicted.
Aggressive pricing by existing competitors and the entrance of new competitors could drive down Stericycle’s profits and slow its growth.
     The regulated waste industry is very competitive because of low barriers to entry, among other reasons. This competition has required Stericycle in the past to reduce its prices, especially to large account customers, and may require it to reduce its prices in the future. Substantial price reductions could significantly reduce its earnings.
     Stericycle faces direct competition from a large number of small, local competitors. Because it requires very little money or technical know-how to compete with Stericycle in the collection and transportation of regulated waste, there are many regional and local companies in the industry. Stericycle faces competition from these businesses, and competition from them is likely to exist in the new locations to which it may expand in the future. In addition, large national companies with substantial resources may decide to enter the regulated waste industry. For example, Waste Management, Inc., a major solid waste treatment company, announced in February 2005 that it intended to begin offering regulated waste management services to hospitals and possibly other large quantity generators of regulated waste.
     Stericycle’s competitors could take actions that would hurt its growth strategy, including the support of regulations that could delay or prevent it from obtaining or keeping permits. They might also give financial support to citizens’ groups that oppose Stericycle’s plans to locate a treatment or transfer facility at a particular location.
Restrictions in Stericycle’s senior unsecured credit facility may limit its ability to pay dividends, incur additional debt, make acquisitions and make other investments.
     Stericycle’s senior unsecured credit facility contains covenants that restrict its ability to make distributions to stockholders or other payments unless it satisfies certain financial tests and complies with various financial ratios.
     It also contains covenants that limit Stericycle’s ability to incur additional indebtedness, acquire other businesses and make capital expenditures, and imposes various other restrictions. These covenants could affect Stericycle’s ability to operate its business and may limit its ability to take advantage of potential business opportunities as they arise.

24


Table of Contents

The loss of Stericycle’s senior executives could affect its ability to manage its business profitably.
     Stericycle depends on a small number of senior executives. Its future success will depend upon, among other things, its ability to keep these executives and to hire other highly qualified employees at all levels. Stericycle competes with other potential employers for employees, and it may not be successful in hiring and keeping the executives and other employees that it needs. Stericycle does not have written employment agreements with any of its executive officers, and officers and other key employees could leave Stericycle with little or no prior notice, either individually or as part of a group. Stericycle’s loss of or inability to hire key employees could impair its ability to manage its business and direct its growth.
Stericycle’s expansion into foreign countries exposes it to unfamiliar regulations and may expose it to new obstacles to growth.
     Stericycle plans to grow both in the United States and in foreign countries. It has established substantial operations in Canada, Mexico, the United Kingdom, Ireland and Argentina. Foreign operations carry special risks. Although Stericycle’s business in foreign countries has not yet been affected, its business in the countries in which it currently operates and those in which it may operate in the future could be limited or disrupted by:
    government controls;
 
    import and export license requirements;
 
    political or economic insecurity;
 
    trade restrictions;
 
    changes in tariffs and taxes;
 
    exchange rate fluctuations;
 
    Stericycle’s unfamiliarity with local laws, regulations, practices and customs;
 
    restrictions on repatriating foreign profits back to the United States; or
 
    difficulties in staffing and managing international operations.
     Foreign governments and agencies often establish permit and regulatory standards different from those in the United States. If Stericycle cannot obtain foreign regulatory approvals, or if it cannot obtain them when it expects, its growth and profitability from international operations could be limited. Fluctuations in currency exchange could have similar effects.
Stericycle’s earnings could decline if it writes off intangible assets, such as goodwill.
     As a result of purchase accounting for its various acquisitions, Stericycle’s balance sheet at December 31, 2006 contains goodwill of $814.0 million and other intangible assets, net of accumulated amortization, of $115.9 million (including indefinite lived intangibles of $32.2 million). In accordance with Statement of Financial Accounting Standards No.142 “Goodwill and Other Intangible Assets”, Stericycle evaluates on an ongoing basis, using the fair value of reporting units, whether facts and circumstances indicate any impairment of the value of indefinite-lived intangible assets such as goodwill. As circumstances after an acquisition can change, Stericycle may not realize the value of these intangible assets. If Stericycle were to determine that a significant impairment has occurred, it would be required to incur non-cash write-offs of the impaired portion of goodwill and other unamortized intangible assets, which could have a material adverse effect on its results of operations in the period in which the write-off occurs.

25


Table of Contents

CAUTIONARY STATEMENT REGARDING FORWARD-LOOKING STATEMENTS
     This proxy statement/prospectus, including the documents incorporated by reference, contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements are generally accompanied by words such as “anticipate,” “expect,” “intend,” “plan,” “believe,” “seek,” “could,” “should,” “will,” “project,” “estimate,” “look forward to” and similar expressions which convey uncertainty of future events or outcomes.
     The expectations set forth in this proxy statement/prospectus and the documents incorporated by reference regarding, among other things, accretion, returns on invested capital, achievement of annual savings and synergies, achievement of strong cash flow, sufficiency of cash flow to fund capital expenditures and achievement of debt reduction targets are only the parties’ expectations regarding these matters. Actual results could differ materially from these expectations depending on factors such as:
    the factors described under “Risk Factors” beginning on page 16 of this proxy statement/prospectus;
 
    the factors that generally affect Stericycle’s and MedSolutions’ businesses as further outlined in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included elsewhere in this proxy statement/prospectus with respect to MedSolutions and included in Stericycle’s 2006 Form 10-K and 2007 Second Quarter Form 10-Q in respect of Stericycle, including the performance of contracts by suppliers, customers and partners; employee management issues; and complexities of global political and economic developments; and
 
    the fact that, following the merger, the actual results of the combined company could differ materially from the expectations set forth in this proxy statement/prospectus and the documents incorporated by reference depending on additional factors such as:
    the combined company’s cost of capital;
 
    the ability of the combined company to identify and implement cost savings, synergies and efficiencies in the time frame needed to achieve these expectations;
 
    the combined company’s actual capital needs, the absence of any material incident of property damage or other hazard that could affect the need to effect capital expenditures and any currently unforeseen merger or acquisition opportunities that could affect capital needs; and
 
    the costs incurred in implementing synergies including, but not limited to, our ability to terminate, amend or renegotiate prior contractual commitments of MedSolutions.
     Actual actions that the combined company may take may differ from time to time as the combined company may deem necessary or advisable in the best interest of the combined company and its shareholders to attempt to achieve the successful integration of the companies, the synergies needed to make the transaction a financial success and to react to the economy and the combined company’s customer market.

26


Table of Contents

STATEMENT REGARDING RATIO OF EARNINGS TO FIXED CHARGES
     The following table shows the ratio of Stericycle’s earnings to fixed charges for the periods shown.
                                                 
                                            Six Months Ended
    Year Ended December 31,   June 30,
    2006   2005   2004   2003   2002   2007
Ratio of earnings to fixed charges(1)
    6.57       8.40       10.64       8.60       4.33       6.81  
 
(1)   For the purpose of calculating the ratio of earnings to fixed charges, earnings consist of income before income taxes plus fixed charges. Fixed charges consist of (i) interest on all indebtedness (including capital leases) and amortization of debt discount and deferred financing fees, (ii) the interest factor attributable to rentals and (iii) interest on liabilities associated with Financial Accounting Standards Board Interpretation No. 48 (“FIN 48”), Accounting for Uncertainty in Income Taxes.

27


Table of Contents

SELECTED HISTORICAL FINANCIAL INFORMATION
Selected Stericycle Historical Financial Data
     Stericycle derived the following historical information from its audited consolidated financial statements for the years ended December 31, 2002, 2003, 2004, 2005 and 2006, and from its unaudited condensed consolidated financial statements for the six months ended June 30, 2007 and 2006. The unaudited condensed consolidated financial statements have been prepared by Stericycle on a basis consistent with the audited financial statements and include, in the opinion of Stericycle’s management, all adjustments, consisting of normal recurring adjustments, necessary for a fair presentation of the information. Operating results for the six months ended June 30, 2007 are not necessarily indicative of the results that may be expected for the entire year ending December 31, 2007. You should read this information in conjunction with (i) Stericycle’s “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and the audited consolidated financial statements and accompanying notes included in its 2006 Form 10-K and (ii) Stericycle’s “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and the unaudited condensed consolidated financial statements and accompanying notes included in its 2007 Second Quarter Form 10-Q. Both Stericycle’s 2006 Form 10-K and its 2007 Second Quarter Form 10-Q are incorporated by reference in this proxy statement/prospectus.
                                                         
                                            Six Months Ended
    Year Ended December 31,   June 30
    2006(3)   2005   2004   2003   2002   2007   2006
    (In thousands except per share data)   Unaudited
Statements of Income Data(1)
                                                       
Revenues
  $ 789,637     $ 609,457     $ 516,228     $ 453,225     $ 401,519     $ 443,894     $ 377,673  
Income from operations
    201,762       166,532       145,655       126,397       100,832       115,447       94,707  
Net income
    105,270       67,154       78,178       65,781       45,724       61,385       48,693  
Net income applicable to common stock
    105,270       67,154       78,178       65,781       45,037       61,385       48,693  
Diluted net income per share of common stock(2)(5)
    1.17       0.74       0.85       0.72       0.51       0.68       0.54  
Depreciation and amortization
    27,036       21,431       21,803       17,255       14,981       14,846       13,008  
Other Data
                                                       
Cash provided by operating activities
  $ 160,162     $ 94,327     $ 114,611     $ 123,887     $ 98,731     $ 70,471     $ 64,349  
Cash used in investing activities
    (201,425 )     (156,001 )     (105,093 )     (57,635 )     (49,470 )     (46,035 )     (143,560 )
Cash (used in) provided by financing activities
    52,547       59,500       (6,941 )     (66,820 )     (53,705 )     (30,799 )     77,691  
 
                                                       
Balance Sheet Data(1)(4)
                                                       
Cash, cash equivalents and short-term investments
  $ 16,040     $ 8,545     $ 7,949     $ 7,881     $ 8,887     $ 2,307     $ 7,292  
Total assets
    1,327,906       1,047,660       834,141       707,462       667,095       1,415,180       1,235,405  
Long-term debt, net of current maturities
    443,115       348,841       190,431       163,016       224,124       508,746       456,825  
Convertible redeemable preferred stock
                      20,944       28,049              
Shareholders’ equity
  $ 625,081     $ 521,634     $ 495,372     $ 407,820     $ 326,729     $ 649,274     $ 574,408  
 
(1)   See Note 4 to Stericycle’s consolidated financial statements included in its 2006 Form 10-K for information concerning Stericycle’s acquisitions during the three years ended December 31, 2006.
 
(2)   See Note 10 to Stericycle’s consolidated financial statements included in its 2006 Form 10-K for information concerning the computation of net income per common share. In 2006, net income includes costs (net of tax) related to a fixed asset write-down of equipment of $0.2 million, a write-down of an investment in securities of $0.6 million and acquisition-related

28


Table of Contents

    costs of $2.1 million, partially offset by income recorded from insurance proceeds related to the settlement of the 3CI Complete Compliance Corporation class action litigation (“3CI litigation”) of $0.6 million, which negatively impacted earnings per share (“EPS”) by $0.09 per share. Of the total of $8.8 million of such items, $7.3 million were non-cash items. In 2005, net income includes costs (net of tax) related to the preliminary settlement of the 3CI litigation of $23.4 million, a write-down of a note receivable of $1.5 million, fixed asset impairments of $0.5 million, acquisition-related costs of $0.5 million, settlement of licensing litigation of $1.1 million and items related to debt restructuring of $0.3 million, which negatively impacted EPS by $0.30 per share. Of the total of $27.3 million of such items, $3.4 million were non-cash items. In 2004, net income includes acquisition-related costs of $0.5 million, fixed asset write-offs of $0.7 million and items related to debt restructuring and redemption of senior subordinated debt of $2.8 million, which negatively impacted EPS by $0.05 per share. Of the total of $4.0 million of such items, $1.4 million were non-cash items. In 2003, net income includes acquisition-related costs (net of tax) of $0.4 million and items related to debt restructuring and subordinated debt repurchases of $2.0 million, which negatively impacted EPS by $0.02 per share. Of the total of $2.4 million of such items, $0.5 million were non-cash items. In 2002, net income includes acquisition-related costs (net of tax) of $0.2 million, fixed asset write-offs of $1.8 million and items related to debt restructuring and subordinated debt repurchases of $1.4 million, which negatively impacted EPS by $0.04 per share. Of the total of $3.4 million of such items, $2.0 million were non-cash items.
 
(3)   On January 1, 2006, Stericycle adopted the provisions of Statement of Financial Accounting Standards No. 123R, “Share-Based Payment” (“SFAS No. 123R”) using the modified prospective method to account for stock compensation costs. SFAS No. 123R requires the measurement and recognition of compensation expense for all stock-based payment awards made to Stericycle’s employees and directors. During the year ended December 31, 2006, Stericycle recognized stock compensation expense of $6.5 million, net of tax. See Note 11 to Stericycle’s consolidated financial statements included in its 2006 Form 10-K for additional information related to its stock compensation expense.
 
(4)   Balance sheet data is as of December 31 of the year in question or as of June 30 for the six months ended June 30, 2007 and 2006.
 
(5)   Per share data adjusted to reflect a 2-for-1 stock split effective May 31, 2007.

29


Table of Contents

COMPARATIVE HISTORICAL AND PRO FORMA PER SHARE INFORMATION
     The following table sets forth selected historical per share data for Stericycle, selected historical data for MedSolutions, and pro forma combined data giving effect to the merger, as if the merger had taken place on January 1, 2006 and as if the merger had taken place on January 1, 2007.
     The data presented below should be read in conjunction with the historical financial statements and related notes of Stericycle and MedSolutions that have been included in this proxy statement/prospectus or incorporated by reference. The pro forma combined data below is for illustrative purposes only. The pro forma combined per share data may not be indicative of the operating results or financial position that would have occurred if the merger had been consummated at the beginning of the periods indicated, and may not be indicative of future operating results or financial position.
                                                                     
    Six Months Ended June 30, 2007     Year Ended December 31, 2006
    (in thousands except share and per share data)     (in thousands except share and per share data)
    Stericycle historical     MedSolutions historical     Pro Forma
Adjustments
    Pro Forma(4)     Stericycle historical       MedSolutions historical     Pro Forma
Adjustments
    Pro Forma  
Net Income
  $ 61,385     $ 191     $ 0     $ 61,576     $ 105,270       $ (807 )   $ 36     $ 104,499  (2)
 
                                                 
Weighted Average Number of Common Shares
Outstanding: (1)
                                                                 
Basic
    87,957,649       24,943,950       (24,943,950 )(5)     87,957,649       88,150,072         22,875,017       (22,875,017 )(5)     88,150,072  
Diluted
    90,203,819       25,196,904       (25,196,904 )(5)     90,203,819       90,213,080         22,875,017       (22,875,017 )(5)     90,213,080  
Earning Per Common Share:
                                                                 
Basic
  $ 0.70     $ 0.00             $ 0.70     $ 1.19       $ (0.04 )           $ 1.19  
 
                                                 
Diluted:
  $ 0.68     $ 0.00             $ 0.68     $ 1.17       $ (0.04 )           $ 1.16  
 
                                                 
 
                                                                 
Assets
  $ 1,415,180     $ 10,593     $ 36,005 (6)   $ 1,461,796     $ 1,327,906       $ 10,837     $ 36,005 (6)   $ 1,338,743  
Total Debt
    522,965       4,221       40,743 (7)     567,947       465,796         4,738       40,743 (7)     470,534  
Owner’s Equity — Book Value
    649,274     $ 4,738               654,012     $ 625,081         3,311               628,392  
Book Value Per Common Share
  $ 7.42     $ 0.18             $ 7.47     $ 7.06       $ 0.14             $ 7.10  
 
                                                 
 
                                                                 
Common Stock cash dividends declared
  $     $             $     $       $             $  
 
                                                 
Preferred Stock cash dividend declared (3)
  $     $             $     $       $ 35.50       (35.50 )(3)   $  
 
                                                 
 
                                                                 
Dividends declared per share
  $     $             $     $       $ 0.37             $  
 
                                                 
 
                                                                 
Common Shares outstanding (1)
    87,534,190       26,164,715       (26,164,715 )(5)     87,534,190       88,503,930         23,780,785       (23,780,785 )(5)     88,503,930  
Preferred Shares outstanding (3)
    0       0       0       0       0         96,667       (96,667 )(3)     0  
 
Note (1): Shares adjusted to reflect a Stericycle 2-for-1 stock split effective May 31, 2007.
 
Note (2): Net income less preferred stock dividends paid of $35,500 as those shares would be canceled.
 
Note (3): Pro forma assumption that preferred stock would be canceled and no dividends would be declared consistent with Stericycle history.
 
Note (4): Pro forma calculation includes consideration for MedSolutions in the form of cash and a promissory note of $0.50 and $1.50, respectively, per outstanding share, including in-the-money options and convertible debt.
 
Note (5): Stericycle share data used.
 
Note (6): Assets reduced by cash consideration of $(13.6) million and increased by intangible assets received of $49.6 million plus or minus any equally offsetting fair value adjustments made.
 
Note (7): Debt increased by note consideration of $40.7 million.

30


Table of Contents

COMPARATIVE MARKET VALUE INFORMATION
Stericycle
     As of July 6, 2007, Stericycle had approximately 180 stockholders of record. Its common stock trades on the NASDAQ National Market under the ticker symbol SRCL. The closing price of a share of Stericycle common stock on July 5, 2007, the day prior to the date that the merger agreement was signed, was $44.93.
MedSolutions
     There were approximately 750 holders of MedSolutions common stock on October 8, 2007. There is no established trading market for MedSolutions common stock. In the opinion of MedSolutions, due to the lack of an active market for the MedSolutions common stock, transactions in the MedSolutions common stock of which MedSolutions is aware are not significant enough to produce representative prices.

31


Table of Contents

INFORMATION ABOUT THE SPECIAL MEETING AND VOTING
     This proxy statement/prospectus is being furnished to MedSolutions shareholders by MedSolutions’ Board of Directors in connection with the solicitation of proxies from the holders of MedSolutions common stock for use at the special meeting of MedSolutions shareholders and any adjournments or postponements of the special meeting. This proxy statement/prospectus also is being furnished to MedSolutions shareholders as a prospectus from Stericycle in connection with its issuance of the promissory notes to MedSolutions shareholders in connection with the merger.
Date, Time and Place
     The special meeting of shareholders of MedSolutions will be held on November 7, 2007 at 10:00 a.m., Dallas, Texas time, at MedSolutions’ corporate headquarters located at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251.
Matters to Be Considered
     At the special meeting, MedSolutions shareholders will be asked:
    to consider and vote upon a proposal to approve and adopt the merger agreement;
 
    to consider and vote upon a proposal to adjourn or postpone the special meeting, if necessary, to solicit additional proxies in favor of the approval and adoption of the merger agreement; and
 
    to consider and transact any other business as may properly be brought before the special meeting or any adjournments or postponements thereof.
     At this time, the MedSolutions Board of Directors is unaware of any matters, other than those set forth in the preceding sentence, that may properly come before the special meeting.
Shareholders Entitled to Vote
     The close of business on October 8, 2007 has been fixed by MedSolutions’ board as the record date for the determination of those holders of MedSolutions common stock who are entitled to notice of, and to vote at, the special meeting and at any adjournments or postponements thereof.
     At the close of business on the record date, there were 26,458,446 shares of MedSolutions common stock outstanding and entitled to vote, held by approximately 750 holders of record. A list of the shareholders of record entitled to vote at the special meeting will be available for examination by MedSolutions shareholders for any purpose germane to the meeting. The list will be available at the meeting and for 10 days prior to the meeting during ordinary business hours by contacting MedSolutions’ Corporate Secretary at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251.
Quorum and Required Vote
     Each holder of record of shares of MedSolutions common stock as of the record date is entitled to cast one vote per share at the special meeting on each proposal. The presence, in person or by proxy, of the holders of one-third of the issued and outstanding shares of MedSolutions common stock outstanding as of the record date constitutes a quorum for the transaction of business at the special meeting. The affirmative vote of the holders of a majority of the shares of MedSolutions common stock entitled to vote at the special meeting is required to approve and adopt the merger agreement.

32


Table of Contents

     In conjunction with the execution of the merger agreement, 50 MedSolutions shareholders entered into a voting agreement with Stericycle and Merger Sub which obligates them to vote their shares of common stock “FOR” the merger agreement. As of the record date, the shareholders subject to the voting agreement with Stericycle and Merger Sub were entitled to vote an aggregate of 15,102,594 shares of MedSolutions, which represented approximately 57.1% of the MedSolutions common stock outstanding and entitled to vote as of the record date.
     As of the record date for the special meeting, directors and executive officers of MedSolutions and their affiliates beneficially owned an aggregate of 3,718,662 shares of MedSolutions common stock entitled to vote at the special meeting. These shares represent approximately 13.6% of the MedSolutions common stock outstanding and entitled to vote as of the record date. Certain of the directors and executive officers of MedSolutions are party to the voting agreement with Stericycle and Merger Sub pursuant to which they have agreed to vote in favor of the approval and adoption of the merger agreement. Although the remaining directors and executive officers of MedSolutions are not party to any such voting agreements with Stericycle or Merger Sub and do not have any obligations to vote in favor of the approval and adoption of the merger agreement, they have indicated their intention to vote their outstanding shares of MedSolutions common stock in favor of the approval and adoption of the merger agreement.
     As of October 8, 2007, Stericycle and its directors, executive officers and their affiliates did not own any of the outstanding shares of MedSolutions common stock.
How Shares Will Be Voted at the Special Meeting
     All shares of MedSolutions common stock represented by properly executed proxies received before or at the special meeting, and not properly revoked, will be voted as specified in the proxies. Properly executed proxies that do not contain voting instructions will be voted FOR the approval and adoption of the merger agreement and any adjournment or postponement of the special meeting.
     A properly executed proxy marked “Abstain” with respect to any proposal will be counted as present for purposes of determining whether there is a quorum at the special meeting. However, because the approval and adoption of the merger agreement requires the affirmative vote of the holders of a majority of the outstanding shares entitled to vote at the special meeting, an abstention will have the same effect as a vote AGAINST approval and adoption of the merger agreement.
     If you hold shares of MedSolutions common stock in “street name” through a bank, broker or other nominee, the bank, broker or nominee may vote your shares only in accordance with your instructions. If you do not give specific instructions to your bank, broker or nominee as to how you want your shares voted, your bank, broker or nominee will indicate that it does not have authority to vote on the proposal, which will result in what is called a “broker non-vote.” Broker non-votes will be counted for purposes of determining whether there is a quorum present at the special meeting, but because approval and adoption of the merger agreement requires the affirmative vote of the holders of a majority of the outstanding shares entitled to vote at the special meeting, broker non-votes will have the same effect as a vote AGAINST the merger agreement.
     If any other matters are properly brought before the special meeting, the proxies named in the proxy card will have discretion to vote the shares represented by duly executed proxies in their sole discretion.

33


Table of Contents

How To Vote Your Shares
     You may vote in person at the special meeting or by proxy. We recommend you vote by proxy even if you plan to attend the special meeting. You can always change your vote at the special meeting.
     You may vote by proxy card by completing and mailing the enclosed proxy card. If you properly submit your proxy card in time to vote, one of the individuals named as your proxy will vote your shares of common stock as you have directed. You may vote for or against the proposals submitted at the special meeting or you may abstain from voting.
     If you hold shares of MedSolutions common stock through a broker or other custodian, please follow the voting instructions provided by that firm. If you do not return your proxy card, or if your shares are held in a stock brokerage account or held by a bank, broker or nominee, or, in other words, in “street name” and you do not instruct your bank, broker or nominee on how to vote those shares, those shares will not be voted at the special meeting.
     If you submit your proxy but do not make specific choices, your proxy will be voted FOR each of the proposals presented.
How To Change Your Vote
     If you are a registered shareholder, you may revoke your proxy at any time before the shares are voted at the special meeting by:
    completing, signing and timely submitting a new proxy to Ms. Beverly Fleeger, Corporate Secretary, at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251 to arrive by the close of business on November 6, 2007; the latest dated and signed proxy actually received by such addressee before the special meeting will be counted, and any earlier proxies will be considered revoked;
 
 
    notifying MedSolutions’ Corporate Secretary, at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251, in writing, by the close of business on November 6, 2007, that you have revoked your earlier proxy; or
 
    voting in person at the special meeting.
     Merely attending the special meeting will not revoke any prior votes or proxies; you must vote at the special meeting to revoke a prior proxy.
     If you hold shares of MedSolutions common stock through a broker or other custodian and you vote by proxy, you may later revoke your proxy instructions by informing the holder of record in accordance with that entity’s procedures.
Solicitation of Proxies
     In addition to solicitation by mail, directors, officers and employees of MedSolutions may solicit proxies for the special meeting from MedSolutions shareholders personally or by telephone, facsimile and other electronic means without compensation other than reimbursement for their actual expenses.
     The expenses incurred in connection with the filing of this document will be paid for by Stericycle. The expenses incurred in connection with the printing and mailing this proxy statement/prospectus will be paid for by MedSolutions. Arrangements also will be made with brokerage firms and other custodians, nominees and fiduciaries for the forwarding of solicitation material to the beneficial owners of shares of

34


Table of Contents

MedSolutions stock held of record by those persons, and MedSolutions will, if requested, reimburse the record holders for their reasonable out-of-pocket expenses in so doing.
Recommendation of the MedSolutions Board of Directors
     The MedSolutions Board of Directors has unanimously approved the merger agreement and the transactions it contemplates, including the merger. The MedSolutions Board of Directors determined that the merger is advisable and in the best interests of MedSolutions and its shareholders and unanimously recommends that you vote FOR approval and adoption of the merger agreement. See “The Merger — MedSolutions’ Reasons for the Merger” beginning on page 39 and “The Merger — Recommendation of the MedSolutions Board of Directors” beginning on page 40 for a more detailed discussion of the MedSolutions Board of Directors’ recommendation.
Special Meeting Admission
     If you wish to attend the special meeting in person, you must present either an admission ticket or appropriate proof of ownership of MedSolutions stock, as well as a form of personal identification. If you are a registered shareholder and plan to attend the meeting in person, please mark the attendance box on your proxy card and bring the tear-off admission ticket with you to the meeting. If you are a beneficial owner of MedSolutions common stock that is held by a bank, broker or other nominee, you will need proof of ownership to be admitted to the meeting. A recent brokerage statement or a letter from your bank or broker are examples of proof of ownership.
     No cameras, recording equipment, electronic devices, large bags, briefcases or packages will be permitted in the meeting.
     PLEASE DO NOT SEND IN ANY MEDSOLUTIONS STOCK CERTIFICATES WITH YOUR PROXY CARD. After the merger is completed, you will receive written instructions from the payment agent informing you how to surrender your stock certificates to receive the merger consideration.
Adjournment and Postponements
     The special meeting may be adjourned from time to time, to reconvene at the same or some other place, by approval of the holders of common stock representing a majority of the votes present in person or by proxy at the special meeting, whether or not a quorum exists, without further notice other than by an announcement made at the special meeting, so long as the new time and place for the special meeting are announced at that time. If the adjournment is for more than 30 days, or if after the adjournment a new record date is determined for the adjourned special meeting, a notice of the adjourned special meeting must be given to each shareholder of record entitled to vote at the special meeting. If a quorum is not present at the MedSolutions special meeting, holders of MedSolutions common stock may be asked to vote on a proposal to adjourn or postpone the MedSolutions special meeting to solicit additional proxies. If a quorum is not present at the MedSolutions special meeting, the holders of a majority of the shares entitled to vote who are present in person or by proxy may adjourn the meeting. If a quorum is present at the MedSolutions special meeting but there are not sufficient votes at the time of the special meeting to approve the merger agreement, holders of MedSolutions common stock may also be asked to vote on a proposal to approve the adjournment or postponement of the special meeting to permit further solicitation of proxies.

35


Table of Contents

THE MERGER
General
     MedSolutions’ Board of Directors is using this document to solicit proxies from the holders of MedSolutions common stock for use at the MedSolutions special meeting, at which holders of MedSolutions common stock will be asked to vote upon approval and adoption of the merger agreement. In addition, Stericycle is sending this document to MedSolutions shareholders as a prospectus in connection with its issuance of the promissory notes in exchange for shares of MedSolutions common stock in the merger.
     The respective Boards of Directors of MedSolutions and Stericycle have unanimously approved the merger agreement providing for the merger of Merger Sub into MedSolutions. MedSolutions will be the surviving corporation in the merger, and upon completion of the merger, the separate corporate existence of Merger Sub will terminate. We expect to complete the merger in the fourth quarter of 2007.
     Stericycle intends to finance the cash portion of the merger consideration through cash on hand and borrowings under its revolving credit facility.
Background of the Merger
     During the month of March 2006, Mr. Jim Karls, Stericycle’s Vice President Corporate Mergers & Acquisitions, contacted Mr. Matthew H. Fleeger, MedSolutions’ President and Chief Executive Officer, by telephone to arrange a meeting at the Waste Expo conference to be held in Las Vegas, Nevada in April 2006. Mr. Fleeger agreed to meet with Stericycle’s representatives at such conference.
     On April 6, 2006, Mr. Fleeger met with Mr. Frank J.M. ten Brink, Stericycle’s Executive Vice President and Chief Financial Officer, Mr. Karls and two additional Stericycle representatives at the Waste Expo conference in Las Vegas, Nevada to discuss the possibility of a business combination between MedSolutions and Stericycle. Mr. Fleeger informed Stericycle that MedSolutions was not currently for sale but that he would be amenable to further discussions in the future.
     On May 1, 2006, Mr. ten Brink sent a letter to Mr. Fleeger reaffirming Stericycle’s interest in pursuing a potential business combination between MedSolutions and Stericycle. MedSolutions did not respond to Mr. ten Brink at such time because MedSolutions was exploring alternative transactions, including a going-private transaction, the sale of a division or selected assets of MedSolutions, or a purchase or consolidation of other companies in MedSolutions’ industry. In October 2006, the MedSolutions Board of Directors decided to explore all options available to MedSolutions and directed Mr. Fleeger to contact Stericycle.
     Prior to traveling to Chicago, Illinois on other business in October 2006, Mr. Fleeger contacted Mr. ten Brink to arrange a meeting to further discuss the possibility of a business combination between MedSolutions and Stericycle. Mr. Fleeger and Mr. ten Brink agreed to meet at Stericycle’s offices in Lake Forest, Illinois on October 4, 2006. Mr. ten Brink stated that, to formulate a proposal, Stericycle needed to review and evaluate certain non-public MedSolutions operational and financial data, and requested that Mr. Fleeger provide such information at the October 4th meeting. Mr. Fleeger stated that he would provide such information if Stericycle entered into a confidentiality agreement with MedSolutions.
     On October 4, 2006, Mr. ten Brink and Mr. Karls met with Mr. Fleeger and Mr. Alan Larosee, MedSolutions’ Vice President, Operations, at Stericycle’s office in Lake Forest, Illinois. Stericycle and MedSolutions entered into a confidentiality agreement at this meeting, and Mr. Fleeger provided to Mr. ten Brink the information regarding MedSolutions that had been requested. During the meeting, Mr. ten Brink expressed an interest in a business combination between MedSolutions and Stericycle. Mr. ten Brink suggested that Stericycle would be willing to pay a yet-to-be determined premium for the common stock of MedSolutions. Mr. Fleeger responded that he would discuss with the MedSolutions Board of Directors Stericycle’s indication of interest.
     On or about October 19, 2006, the Board of Directors of MedSolutions met by telephonic conference and Mr. Fleeger reported to the directors the discussions with Mr. ten Brink at the October 4, 2006

36


Table of Contents

meeting. Following a discussion of the matter, the MedSolutions Board of Directors authorized MedSolutions to conduct exploratory communications with Stericycle’s management regarding a possible business combination.
     On October 12, 2006, Mr. Fleeger and Mr. J. Steven Evans, MedSolutions’ Vice President Finance, received a letter from Mr. Karls requesting additional information regarding MedSolutions. MedSolutions subsequently provided additional information responsive to Mr. Karl’s request to Stericycle.
     On December 18, 2006, Mr. ten Brink sent proposed terms for a business combination between Stericycle and MedSolutions to Mr. Fleeger by facsimile. The proposed terms provided for a price per share of approximately $1.56, to be paid approximately 50% in cash and 50% in promissory notes.
     On December 19, 2006, a regulary scheduled meeting of the Board of Directors of MedSolutions was held, during which Mr. Fleeger updated the directors on the conversations to date with Stericycle. The directors discussed the Stericycle level of interest and concluded that the tentative indication of value at approximately $1.56 per share of MedSolutions common stock warranted continued dialogue with Stericycle. Upon deliberation, the MedSolutions Board of Directors determined that MedSolutions’ management should continue discussions with Stericycle and that MedSolutions and its advisors should seek an increase in the consideration to be paid by Stericycle. The MedSolutions Board of Directors also authorized MedSolutions’ management to conduct discussions with a third party that had expressed interest in a potential business combination with MedSolutions. On December 23, 2006, Mr. Fleeger communicated to Mr. ten Brink that MedSolutions’ Board of Directors had reviewed Stericycle’s tentative proposal but had not reached a conclusion on it.
     During January 2007, MedSolutions’ management conducted negotiations with a third party that had expressed an interest in either acquiring MedSolutions by way of merger or purchasing substantially all of the assets and assuming certain of the liabilities of MedSolutions. The third party’s management initially proposed to pay approximately $45,000,000 (approximately $1.66 per share of MedSolutions common stock) in either a merger transaction or an asset transaction, approximately 70% of which would be in the form of cash and 30% of which would be in the form of notes payable over five years. However, after failing to obtain the approval of its board of directors for the proposed transaction terms, the third party’s management lowered its proposed purchase price for MedSolutions. After consultation with MedSolutions’ Board of Directors, MedSolutions’ management informed the third party that the newly proposed terms were unacceptable and terminated negotiations with such third party.
     On February 19, 2007, Mr. ten Brink sent revised proposed terms for a business combination between Stericycle and MedSolutions to Mr. Fleeger by email. The proposed terms provided for a price per share of approximately $2.00, to be paid 25% in cash and 75% in promissory notes. Stericycle’s and MedSolutions’ agreement to use promissory notes as part of the merger consideration is a result of Stericycle’s objectives of conserving its cash, avoiding additional borrowings under its revolving credit facility, and paying less than $2.00 per share for MedSolutions common stock on a present value basis using any discount rate greater than 4.5%. After receipt of such proposal, the Board of Directors of MedSolutions met by telephonic conference in order to consider Stericycle’s revised proposal. After deliberation, the MedSolutions Board of Directors directed Mr. Fleeger to continue to negotiate the terms for a proposed business combination with Stericycle.
     Several drafts of the proposed terms for the business combination were negotiated and revised by Stericycle, MedSolutions and their respective legal counsel between February 19 and March 7, 2007. In a telephone conversation regarding such revised drafts, Mr. ten Brink requested that Stericycle and MedSolutions enter into an additional confidentiality agreement permitting Stericycle to conduct additional due diligence, and an exclusivity agreement providing for an exclusivity period of 75 days during which MedSolutions would not seek or consider alternative business combination transactions. Stericycle’s legal counsel provided drafts of the proposed confidentiality agreement and exclusivity agreement to legal counsel for MedSolutions on March 7, 2007. Additional revisions were made by legal

37


Table of Contents

counsel for each of Stericycle and MedSolutions to the proposed terms for the business combination, the confidentiality agreement and the exclusivity agreement on March 7 and March 8, 2007.
     On March 7, 2007, the MedSolutions Board of Directors met by telephonic conference to discuss the proposed terms for the business combination, the confidentiality agreement and the exclusivity agreement. After deliberation, the MedSolutions Board of Directors authorized Mr. Fleeger to execute the confidentiality agreement and the exclusivity agreement on behalf of MedSolutions, subject to review of the definitive confidentiality agreement and exclusivity agreement by outside legal counsel to MedSolutions.
     During the week of March 12, 2007, Mr. Karls and a team of Stericycle representatives met with Mr. Fleeger, Mr. Evans, Mr. Larosee and other MedSolutions representatives at MedSolutions’ offices in Dallas, Texas to conduct due diligence on MedSolutions and further discuss the prospect of a merger between the companies. During March and April 2007, Stericycle completed its due diligence of MedSolutions.
     On April 16, 2007, MedSolutions engaged Van Amburgh to render a written opinion to the Board of Directors of MedSolutions regarding the fairness of the merger consideration to be received in connection with the merger by the holders of MedSolutions common stock from a financial point of view.
     On April 4, 2007, Stericycle distributed a draft merger agreement and a draft voting agreement prepared by Johnson and Colmar, Stericycle’s outside legal counsel, to MedSolutions and its outside legal counsel at that time, Fish & Richardson P.C. Over the following three months, the managements of MedSolutions and Stericycle and their respective financial advisors and outside legal counsel engaged in negotiations with respect to the merger agreement. The merger consideration was basically agreed to in the early drafts of the merger agreement. The most contentious points left to be resolved involved set offs to the merger consideration based on Stericycle’s due diligence investigation of MedSolutions and the ability to adjust the merger consideration downward after closing the transaction. As a result of Stericycle’s due diligence regarding trends in MedSolutions’ revenues and earnings, the parties agreed to extend the maturity date of the promissory notes from five years to seven years to avoid any downward adjustment in the original principal amount of the promissory notes. The right to reduce the principal amount of the promissory notes after the merger is consummated was also significantly negotiated. Because a large verdict was rendered against MedSolutions during these negotiations, Stericycle insisted on adjusting the merger consideration to the extent the judgment is not paid-in-full by MedSolutions’ insurance carrier. A cap on the liabilities Stericycle will assume was negotiated and any excess liabilities on MedSolutions’ books at the closing would adjust downward the merger consideration. Adjusting the merger consideration for a breach of MedSolutions’ representations and warranties was not subject to meaningful negotiation, but the length of time those representations and warranties stay in effect was negotiated. Finally, the potential downward adjustment to the merger consideration based on the gross revenues realized from certain customers of MedSolutions for the three months following closing was the subject of a good deal of negotiation in terms of selecting those customers and the measurement period of their revenue recognition.
     MedSolutions’ Board of Directors held a telephonic meeting on July 5, 2007 to review the proposed transaction. MedSolutions’ valuation advisor and Block & Garden, LLP, MedSolutions’ new outside legal counsel, also attended the meeting. At the meeting, MedSolutions’ Board of Directors discussed various aspects of the proposed transaction, including the proposed merger consideration, the terms of the merger agreement, and the written fairness opinion rendered by Van Amburgh that, as of the date of the opinion and based on and subject to the matters described in the opinion, the merger consideration to be received in the merger by the holders of MedSolutions common stock was fair, from a financial point of view, to such holders. MedSolutions’ outside legal counsel presented a summary of the terms of the merger agreement and discussed various legal issues with MedSolutions’ directors, including without limitation their fiduciary duties to MedSolutions’ shareholders. After further discussion on certain aspects of the proposed transaction, MedSolutions’ Board of Directors unanimously approved the merger, the terms of the merger agreement and the transactions contemplated by the merger agreement, and determined to recommend adoption of the merger agreement to the shareholders of MedSolutions.
     The MedSolutions Board of Directors considered appointing a special committee of outside directors to review the proposed merger with Stericycle, but having only five members, one of which is the President and Chief Executive Officer of MedSolutions, one of which is legal counsel to MedSolutions in connection with the merger, and two of which are creditors of MedSolutions, that would leave only one director, who was placed on the MedSolutions Board of Directors as the representative of MedSolutions’ largest shareholder, Tate Investments, LLC. The MedSolutions Board of Directors believed that the indebtedness owing to two directors would not factor into their decision on examining the merger as MedSolutions was in a much improved financial condition at the time of the proposed merger than when the loans were initially made. The MedSolutions Board of Directors also believed that its legal counsel would not be influenced by his relationship with MedSolutions in reviewing the merits of the proposed merger. Accordingly, the MedSolutions Board of Directors believed that the interests of the MedSolutions shareholders would be best served by the group acting in concert as opposed to one individual director making such an important decision.
     The Board of Directors of Stericycle approved the merger agreement in its then current form and the transaction contemplated by the merger agreement by the directors’ unanimous written consent as of June 14, 2007. The directors’ consent authorized Stericycle’s executive officers to enter into a merger agreement in a form and on terms substantially consistent with the form and terms approved by the directors.
     On July 6, 2007, following the approval by the boards of directors of both companies, Stericycle and MedSolutions executed the merger agreement. On July 6, 2007, MedSolutions publicly announced the execution of the merger agreement.
     Prior to the MedSolutions Board of Directors’ approval of entering into the confidentiality agreement and the exclusivity agreement with Stericycle mentioned above, management of MedSolutions actively solicited interest in a business combination or outright sale of MedSolutions with several companies in its industry as well as several private equity firms. At best, only a passing interest was expressed by the industry companies, and the private equity firms indicated that the financial terms of any transaction would be lower than those initially proposed by Stericycle in December 2006.

38


Table of Contents

MedSolutions’ Reasons for the Merger
     The MedSolutions Board of Directors, at a special meeting held on July 5, 2007, unanimously determined that the merger and the merger agreement are advisable, fair to and in the best interests of MedSolutions and its shareholders. The MedSolutions Board of Directors has approved the merger agreement and unanimously recommends MedSolutions shareholders vote “FOR” approval and adoption of the merger agreement and the merger.
     In reaching its decision, the MedSolutions Board of Directors consulted with MedSolutions’ management and its valuation and legal advisors in this transaction. In concluding that the merger is in the best interests of MedSolutions and its shareholders, the MedSolutions Board of Directors considered a variety of factors, including the following:
    the financial presentation of Van Amburgh, including its opinion dated June 30, 2007, to the MedSolutions Board of Directors as to the fairness, from a financial point of view and as of the date of the opinion, of the merger consideration, as more fully described below under “— Opinion of MedSolutions’ Valuation Advisor”;
 
    the MedSolutions Board of Directors’ familiarity with, and understanding of, MedSolutions’ business, financial condition, results of operations, current business strategy, earnings and prospects, and its understanding of Stericycle’s business, financial condition, results of operations, business strategy and earnings;
 
    the possible alternatives to the merger, including:
    other acquisition or combination possibilities for MedSolutions; and
 
    the possibility of continuing to operate as an independent regulated medical waste management company under its current model focused in the southern and northeastern United States;
    the range of possible benefits to MedSolutions’ shareholders of those alternatives and the timing and likelihood of accomplishing the goal of any of those alternatives, and the Board’s assessment that the merger with Stericycle presents an opportunity superior to those alternatives;
 
    the fact that MedSolutions shareholders will receive substantial and adequate total consideration for their shares;
 
    the MedSolutions Board of Directors’ understanding, following its review together with MedSolutions’ management and valuation advisors, of overall market conditions, and the Board’s determination that, in light of these factors, the timing of a potential transaction was favorable to MedSolutions and its shareholders; and
 
    the consideration by the MedSolutions Board of Directors, with the assistance of its advisors, of the general terms and conditions of the merger agreement, including the parties’ representations, warranties and covenants, the conditions to their respective obligations as well as the likelihood of consummation of the merger, the proposed transaction structure, the termination provisions of the agreement and the MedSolutions Board of Directors’ evaluation of the likely time period necessary to close the transaction.
     The MedSolutions Board of Directors viewed all of the foregoing bullet points as favorably disposed to the merger. The valuation opinion reflected that MedSolutions’ shareholders were receiving fair value for their common stock. Another acquisition or merger party was remote, and continuing to operate independently, with the risks inherent therein, was not nearly attractive as the assuredness of receiving the merger consideration offered in the merger. Finally, the terms and conditions of the merger agreement, including the representations, warranties, covenants and indemnities MedSolutions was required to give, were fair to MedSolutions and did not pose undue risk that the merger consideration would be materially negatively adjusted as a result thereof.
     The MedSolutions Board of Directors also considered potential risks associated with the merger in connection with its evaluation of the proposed transaction, including:
    the risks of the type and nature described under “Risk Factors” beginning on page 16;

39


Table of Contents

    the risk, which is common in transactions of this type, that the terms of the merger agreement, including provisions relating to Stericycle’s right to obtain information with respect to any alternative proposals and to a five-day negotiating period after receipt by MedSolutions of a superior proposal and MedSolutions’ payment of a termination fee under specified circumstances, might discourage other parties that could otherwise have an interest in a business combination with, or an acquisition of, MedSolutions from proposing such a transaction;
 
    the interests of certain of MedSolutions’ executive officers and directors described under “Interests of MedSolutions Directors and Executive Officers in the Merger” beginning on page 49;
 
    the restrictions on the conduct of MedSolutions’ business prior to the consummation of the merger, requiring MedSolutions to conduct its business in the ordinary course consistent with past practices subject to specific limitations, which may delay or prevent MedSolutions from undertaking business opportunities that may arise pending completion of the merger; and
 
    the risks and contingencies related to the announcement and pendency of the merger, the possibility that the merger will not be consummated and the potential negative effect of public announcement of the merger on MedSolutions’ business and relations with customers and service providers, and operating results and MedSolutions’ ability to retain key management and personnel.
     The MedSolutions Board of Directors believed that the risk factors mentioned above were either not relevant, such as in the case with respect to the risk factor that MedSolutions may not be permitted to negotiate an alternative proposal to the merger (that prohibition lapsed prior to executing the merger agreement), or were neutral, such as the risk factors requiring MedSolutions to conduct its business in the ordinary course and the potential negative impact of not closing the merger once the proposed transaction was publicly announced.
     The MedSolutions Board of Directors discussed the loss of its shareholders’ ongoing investment in MedSolutions, but concluded that, in light of the risks of continued ownership and the great uncertainty of the value of an investment in MedSolutions, such continued ownership was not in the best interests of MedSolutions’ shareholders at the present time compared to the merger and the merger consideration to be paid to such shareholders, notwithstanding that the merger consideration is subject to downward adjustment. The adjustments, if any, would be losses realized by MedSolutions if it remained independent, other than any adjustments as a result of a breach of a representation and warranty by MedSolutions which the MedSolutions Board of Directors believes to be of very modest risk. For example, a downward adjustment to the merger consideration as a result of increased liabilities, loss of revenues, or payment of a litigation judgment would all equally negatively affect the value of a shareholder’s interest in MedSolutions.
     The MedSolutions Board of Directors did not consider the fact that financial data for the period after March 31, 2007 was not provided to Van Amburgh to be material to its review of the fairness opinion as the financial condition of MedSolutions between March 31, 2007 and June 30, 2007 did not materially change. No significant events affecting MedSolutions’ business or operations occurred between March 31, 2007 and June 30, 2007 other than the verdict rendered against EMSI as described in the section entitled “The Merger Agreement-Adjustments to Merger Consideration-Litigation Adjustment” on page 61 of the proxy statement/prospectus.
     The foregoing discussion of the information and factors discussed by the MedSolutions Board of Directors is not exhaustive but does include material factors considered by the MedSolutions Board of Directors. The MedSolutions Board of Directors did not quantify or assign any relative or specific weight to the various factors that it considered. Rather, the MedSolutions Board of Directors based its recommendation on the totality of the information presented to and considered by it. In addition, individual members of the MedSolutions Board of Directors may have given different weight to different factors.
Recommendation of the MedSolutions Board of Directors
     After careful consideration of the matters discussed above, the MedSolutions Board of Directors concluded that the proposed merger is in the best interest of the shareholders of MedSolutions.
     FOR THE REASONS SET FORTH ABOVE, THE BOARD OF DIRECTORS OF MEDSOLUTIONS HAS UNANIMOUSLY ADOPTED THE MERGER AGREEMENT AS IN THE BEST INTERESTS OF MEDSOLUTIONS AND ITS SHAREHOLDERS, AND UNANIMOUSLY RECOMMENDS THAT MEDSOLUTIONS SHAREHOLDERS VOTE FOR THE ADOPTION OF THE MERGER AGREEMENT.
Stericycle’s Reasons for the Merger
     Stericycle anticipates that the acquisition of MedSolutions will increase Stericycle’s revenues and improve its operating margins by increasing route densities and expanding the geographic areas that it is able to serve efficiently. Because Stericycle uses a “hub and spoke” configuration of treatment facilities and transfer stations, the addition of MedSolutions’ customers and facilities will increase the number of customers that can be served by Stericycle’s existing routes or by new routes resulting from a realignment as appropriate of Stericycle’s and MedSolutions’ routes, thereby reducing per-stop collection costs, and the addition of MedSolutions’ facilities will shorten travel distances, thereby reducing overall transportation costs.

40


Table of Contents

Opinion of MedSolutions’ Valuation Advisor
     Van Amburgh has rendered its written opinion, dated June 30, 2007, to the Board of Directors of MedSolutions to the effect that, as of that date and subject to the assumptions, limitations, qualifications and other matters described in its opinion, the merger consideration to be received in connection with the merger by the holders of MedSolutions common stock was fair, from a financial point of view, to such holders.
     The full text of Van Amburgh’s written opinion to MedSolutions’ Board of Directors, which sets forth the procedures followed, the assumptions made, qualifications and limitations on the review undertaken and other matters, is attached to this proxy statement/prospectus as Annex C. The summary of Van Amburgh’s opinion in this proxy statement/prospectus is qualified in its entirety by reference to the full text of the opinion, which is incorporated by reference into this proxy statement/prospectus. Holders of MedSolutions common stock are encouraged to read the opinion in its entirety.
     The opinion of Van Amburgh does not constitute a recommendation as to how any shareholder should vote on the merger or any matter relevant to the merger agreement.
General
     Van Amburgh was selected by MedSolutions’ Board of Directors based on Van Amburgh’s qualifications, expertise and reputation. Van Amburgh is a nationally recognized valuation firm, and is regularly engaged in the evaluation of capital structures, valuation of businesses and their securities in connection with mergers and acquisitions, negotiated underwritings, competitive biddings, secondary distributions of listed and unlisted securities, private placements, financial restructurings and other financial services.
     In the past, Van Amburgh and its affiliates have provided financial advisory services to MedSolutions unrelated to the merger for which they have received compensation. MedSolutions retained Van Amburgh in 2006 to provide financial advisory services in connection with its acquisition of SteriLogic Waste Systems, Inc. Van Amburgh or its affiliates may, in the future, provide investment banking and financial advisory services to Stericycle for which they would expect to receive compensation.
     Pursuant to an engagement letter between MedSolutions and Van Amburgh dated April 16, 2007, Van Amburgh was retained to render a written opinion to the Board of Directors of MedSolutions regarding the fairness of the merger consideration to be received, as subject to adjustment as set forth in the merger agreement, in connection with the merger by the holders of MedSolutions common stock from a financial point of view. On June 30, 2007, Van Amburgh rendered its written opinion to the Board of Directors of MedSolutions that, as of that date and subject to the assumptions, limitations, qualifications and other matters described in its opinion, the merger consideration to be received in connection with the merger by the holders of MedSolutions common stock was fair, from a financial point of view, to such holders. Van Amburgh received a fee of $17,500 for rendering such opinion, which was not contingent upon the completion of the merger. MedSolutions and Van Amburgh mutually determined the amount of the fee payable to Van Amburgh for rendering such opinion.
     The opinion of Van Amburgh was one of many factors taken into consideration by MedSolutions’ Board of Directors in making its determination to approve the merger and should not be considered determinative of the views of MedSolutions’ Board of Directors or management with respect to the merger or the merger consideration.

41


Table of Contents

     Van Amburgh did not establish the amount of cash or the principal amount of the promissory note that will be received in exchange for each share of MedSolutions common stock as consideration for the merger. These amounts were determined pursuant to negotiations between MedSolutions and Stericycle and were approved by the Board of Directors of MedSolutions.
Procedures Followed
     In connection with rendering its opinion, Van Amburgh has, among other things:
    reviewed a draft of the merger agreement and discussed with the officers of MedSolutions the course of other negotiations with Stericycle;
 
    reviewed certain financial and other information about MedSolutions that was publicly available and that Van Amburgh deemed relevant;
 
    reviewed certain internal financial and operating information, including financial projections relating to MedSolutions that were provided to Van Amburgh by MedSolutions, taking into account (a) the growth prospects of MedSolutions, (b) MedSolutions’ historical and current fiscal year financial performance and track record of meeting its forecasts, and (c) MedSolutions’ forecasts going forward and its ability to meet them;
 
    met with MedSolutions’ management regarding the business prospects, financial outlook and operating plans of MedSolutions, and held discussions concerning the impact on MedSolutions and its prospects of the economy and the conditions in MedSolutions’ industry;
 
    compared the valuation in the public market of companies Van Amburgh deemed similar to that of MedSolutions in market, services offered, and size;
 
    reviewed public information concerning the financial terms of certain recent transactions that Van Amburgh deemed comparable to the merger; and
 
    performed a discounted cash flow analysis to analyze the present value of the future cash flow streams that MedSolutions has indicated it expects to generate.
     In addition, Van Amburgh conducted such other studies, analyses and investigations and considered such other financial, economic and market factors and criteria as they considered appropriate in arriving at their opinion. Van Amburgh’s analyses must be considered as a whole. Considering any portion of such analyses or factors, without considering all analyses and factors, could create a misleading or incomplete view of the process underlying the conclusions expressed in the opinion delivered by Van Amburgh.
Assumptions Made and Qualifications and Limitations on Review Undertaken
     In rendering its opinion, Van Amburgh assumed and relied upon the accuracy and completeness of all of the financial information, forecasts and other information provided to or otherwise made available to Van Amburgh by MedSolutions or that was publicly available to Van Amburgh, and did not attempt, or assume any responsibility, to independently verify any of such information. The opinion of Van Amburgh is expressly conditioned upon such information, whether written or oral, being complete and accurate. In addition, in rendering its opinion, Van Amburgh assumed that the forecasts provided by MedSolutions had been reasonably prepared on bases reflecting the best currently available information, estimates and judgments of MedSolutions’ management as to the future financial performances of MedSolutions. The forecasts projected that MedSolutions would have gross revenues of $16,061,448 and net income of $1,096,816 in fiscal year 2007. The forecasts provided by MedSolutions were reviewed by Van Amburgh in comparison to MedSolutions’ historical financial results. Based upon such review, Van Amburgh deemed the forecasts to be reasonable in terms of achievability.

42


Table of Contents

     Van Amburgh assumed that the merger will be consummated in accordance with the merger agreement. In addition, Van Amburgh’s opinion noted that:
    they have not conducted a physical inspection of MedSolutions’ properties and facilities;
 
    they have not made nor obtained any evaluations or appraisals of the assets or liabilities (including without limitation any potential environmental liabilities) of MedSolutions;
 
    their opinion is based upon market, economic and other conditions as they exist on, and can be evaluated as of, the date of the opinion;
 
    they assumed that there were no significant events impacting MedSolutions’ historical profitability between March 31, 2007 and June 30, 2007; and
 
    their opinion does not address the relative merits of the merger as compared to other transactions or business strategies that might be available to MedSolutions, nor does it address MedSolutions’ underlying business decision to proceed with the merger.
Summary of Financial and Other Analyses
     The following is a summary of the material financial and other analyses presented by Van Amburgh to MedSolutions’ Board of Directors in connection with Van Amburgh’s opinion dated June 30, 2007. The financial and other analyses summarized below include information presented in tabular format. In order to fully understand Van Amburgh’s analyses, the tables must be read together with the text of each summary. The tables alone do not constitute a complete description of the analyses. Considering the data in the tables below without considering the full narrative description of the financial and other analyses, including the methodologies underlying and the assumptions, qualifications and limitations affecting each analysis, could create a misleading or incomplete view of Van Amburgh’s analyses.
     Overview
     Van Amburgh analyzed the value of MedSolutions in accordance with the following methodologies, each of which is described in more detail below:
    Discounted Cash Flow Analysis;
 
    Guideline Company Analysis; and
 
    Adjusted Book Value Analysis.
     These methodologies were used to determine an implied price range per share of MedSolutions common stock, which was then compared to the merger consideration. The following table summarizes the results of the analyses and should be read together with the more detailed descriptions set forth below:
         
    Fair Market Value
Methodology   Estimate Range
Discounted Debt-Free Net Cash Flow (Income) Approach to Value
  $ 37,100,000 to $45,400,000  
Guideline Company (Market) Approach to Value
  $ 38,600,000 to $41,700,000  
Adjusted Book Value (Cost) Approach to Value
    N/A  
Total Range
  $ 37,100,000 to $45,400,000  

43


Table of Contents

     Discounted Cash Flow Analysis
     Van Amburgh’s first valuation analysis was based upon the Discounted Debt-Free Net Cash Flow (Income) Approach to Value. This approach involved a projection of future revenues and expenses based upon present operations and expectations. The calculated earnings stream was discounted back to present value at discount rates ranging from 14% to 16%, a weighted average cost of capital (discount rate) range believed by Van Amburgh to balance the potential risks with the potential rewards as viewed by an objective investor. Values in a range from $37,100,000 (using a 16% discount rate) to $45,400,000 (using a 14% discount rate) were determined using this approach.
     Guideline Company Analysis
     Van Amburgh’s second analysis was based upon the Guideline Company (Market) Approach to Value. Values determined from recent minority public guideline company trades, private sale transactions, possible transaction indicators, planned trades, and/or trades of equivalent assets were considered under this approach. Fair market value estimates in a range from $38,600,000 to $41,700,000 were determined using this approach.
     The selected companies used by Van Amburgh in the Guideline Company Analysis were:
    Donno Compant;
 
    SteriLogic Waste Systems, Inc.;
 
    Miners Group;
 
    A&J Cartage, Inc.;
 
    Waste Stream Environmental, Inc.;
 
    Romic Environmental Technologies Corporation;
 
    Bonham Management Group, Inc.;
 
    Liberty Disposal, Inc.;
 
    Incendere, Inc.;
 
    7-7, Inc.;
 
    Stericycle, Inc.;
 
    American Ecology Corporation;
 
    Microtek Medical Holdings, Inc.; and
 
    Steris Corporation.
     The comparable guideline companies included in the Guideline Company Analysis were all operating within Standard Industrial Classification (“SIC”) code number 4953, Refuse Systems. The private company sales transactions (10 transactions) were selected from a comparable company search of SIC code number 4953 transactions using the “Pratt’s Stats” computer database of private sales transactions. The only companies excluded were companies that operated landfills, trash hauling operations, container manufacturers, and other sectors that bore no relation to medical waste or hazardous waste processing. The public company guideline transactions consisted of five publicly-traded guideline companies. The selection process involved both an SIC code number 4953 search and text searches (“medical waste,” “hazardous waste,” “refuse systems,” “waste removal,” and “waste disposal”). The SIC code number 4953 and text searches were performed using the “10-K Wizard” database, which accesses the SEC’s EDGAR database. Additional financial information and stock price information was secured from Yahoo Finance. No companies were excluded from Van Amburgh’s public company analysis.
     Adjusted Book Value Analysis
     Van Amburgh’s third analysis was based upon the Adjusted Book Value (Cost) Approach to Value. This analysis required adjusting each asset and each actual and potential liability of MedSolutions to present fair market value in order to establish the present estimated cost of duplicating the assets and liabilities of its business. The value indicated by this analysis often understates the fair market value of the subject company because it does not consider goodwill and other elements of intangible value. Due to the earnings potential of MedSolutions and the presence of significant intangible asset value, the Adjusted Book Value (Cost) Approach to Value was calculated more for informational purposes than for value

44


Table of Contents

indication purposes. The book value of MedSolutions’ shareholders’ equity was $4,606,561 as of the date of Van Amburgh’s opinion. Van Amburgh disregarded this valuation method because it did not believe it accurately reflected MedSolutions’ value.
     After these three approaches to value were considered, the applicability and practical application of each were examined by Van Amburgh and other relevant factors were weighted. Based upon Van Amburgh’s personnel’s experience in valuing closely-held companies, the most representative value of 100% of MedSolutions’ common stock, as of the date of their opinion, was in a range from $37,100,000 to $45,400,000. The total amount to be paid by Stericycle to MedSolutions shareholders pursuant to the merger agreement is $54,323,871.
Conclusion
     Van Amburgh determined and issued its written opinion to the Board of Directors of MedSolutions to the effect that as of June 30, 2007, and subject to the assumptions, limitations, qualifications and other matters described in its opinion, the merger consideration to be received in connection with the merger by the holders of MedSolutions common stock was fair, from a financial point of view, to such holders.
Accounting Treatment
     Stericycle will account for the merger using the purchase method of accounting.
Regulatory Matters
     Other than as we describe in this document, the merger does not require the approval of any other U.S. federal or state or foreign agency.
Appraisal and Dissenters’ Rights
     Under the Texas Business Corporation Act (the “TBCA”), you have the right to demand appraisal in connection with the merger and to receive, in lieu of the merger consideration, payment in cash, without interest, for the fair value of your shares of MedSolutions common stock as determined by an appraiser selected in a Texas state court proceeding. Holders of MedSolutions common stock electing to exercise appraisal rights must comply with the provisions of Article 5.12 of the TBCA in order to perfect their rights. MedSolutions will require strict compliance with the statutory procedures.
     The following is intended as a summary of the material provisions of the Texas statutory procedures required to be followed by a MedSolutions shareholder in order to demand and perfect appraisal rights. Shareholders who desire more information than provided in the following summary should review Article 5.12 of the TBCA, the full text of which appears in Annex D to this proxy statement/prospectus.
     This proxy statement/prospectus constitutes MedSolutions’ notice to its shareholders of the availability of appraisal rights in connection with the merger in compliance with the requirements of Article 5.12 of the TBCA. If you wish to consider exercising your appraisal rights, you should carefully review the text of Article 5.12 contained in Annex D since failure to timely and properly comply with the requirements of Article 5.12 will result in the loss of your appraisal rights under Texas law.
     If you elect to demand appraisal of your shares of MedSolutions common stock, you must satisfy each of the following conditions:

45


Table of Contents

    prior to the special meeting you must deliver to MedSolutions a written objection to the merger and your intention to exercise your right to dissent in the event that the merger is effected and setting forth the address at which notice shall be delivered in that event;
 
    this written objection must be in addition to and separate from any proxy or vote abstaining from or voting against the adoption of the merger agreement. Voting against or failing to vote for the adoption of the merger agreement by itself does not constitute a demand for appraisal within the meaning of Article 5.12;
 
    you must not vote in favor of the adoption of the merger agreement. A vote in favor of the adoption of the merger agreement, by proxy or in person, will constitute a waiver of your appraisal rights in respect of the shares so voted and will nullify any previously filed written demands for appraisal. Failing to vote against adoption of the merger agreement will not constitute a waiver of your appraisal rights;
 
    you must continuously hold your shares through the effective time of the merger.
     If you fail to comply with any of these conditions and the merger is completed, you will be entitled to receive the fixed combination of the cash consideration and the note consideration for each share of MedSolutions common stock as provided for in the merger agreement if you are the holder of record at the effective time of the merger, but you will have no appraisal rights with respect to your shares of MedSolutions common stock. A proxy card which is signed and does not contain voting instructions will, unless revoked, be voted “FOR” the adoption of the merger agreement and will constitute a waiver of your right of appraisal and will nullify any previous written demand for appraisal.
     All written objections should be addressed to MedSolutions’ Secretary at 12750 Merit Drive, Park Central VII, Suite 770, Dallas, Texas 75251, and should be executed by, or on behalf of, the record holder of the shares in respect of which appraisal is being demanded. The written objection must reasonably inform MedSolutions of the identity of the shareholder and the intention of the shareholder to demand appraisal of his, her or its shares.
     To be effective, a written objection by a holder of MedSolutions common stock must be made by or on behalf of the shareholder of record. The written objection should set forth, fully and correctly, the shareholder of record’s name as it appears on his or her stock certificate(s) and should specify the holder’s mailing address and the number of shares registered in the holder’s name. The written objection must state that the person intends to exercise his, her or its right to dissent under Texas law in connection with the merger. Beneficial owners who do not also hold the shares of record may not directly make appraisal demands to MedSolutions. The beneficial holder must, in such cases, have the record owner submit the required demand in respect of those shares. If shares are owned of record in a fiduciary capacity, such as by a trustee, guardian or custodian, execution of a written objection should be made in that capacity; and if the shares are owned of record by more than one person, as in a joint tenancy or tenancy in common, the written objection should be executed by or for all joint owners. An authorized agent, including an authorized agent for two or more joint owners, may execute the written objection for appraisal for a shareholder of record; however, the agent must identify the record owner or owners and expressly disclose the fact that, in executing the written objection, he or she is acting as agent for the record owner. A record owner, such as a broker, who holds shares as a nominee for others, may exercise his or her right of appraisal with respect to the shares held for one or more beneficial owners, while not exercising this right for other beneficial owners. In that case, the written objection should state the number of shares as to which appraisal is sought. Where no number of shares is expressly mentioned, the written objection will be presumed to cover all shares held in the name of the record owner.

46


Table of Contents

     If you hold your shares of MedSolutions common stock in a brokerage account or in other nominee form and you wish to exercise appraisal rights, you should consult with your broker or the other nominee to determine the appropriate procedures for the making of a demand for appraisal by the nominee.
     Within 10 days after the effective time of the merger, the surviving corporation to the merger must give written notice that the merger has become effective to each MedSolutions shareholder who has properly filed a written objection and who did not vote in favor of the merger agreement. Each shareholder who has properly filed a written objection has 10 days from the delivery or mailing of the notice to make written demand for payment of the fair value for the shareholder’s shares. The written demand must state the number of shares owned by the shareholder and the fair value of the shares as estimated by the shareholder. Any shareholder who fails to make written demand within 10 days of the delivery or mailing of the notice from the surviving corporation that the merger has become effective will not be entitled to any appraisal rights. Any shareholder making a written demand for payment must submit to the surviving corporation for notation any certificated shares held by that shareholder which are subject to the demand within 20 days after making the written demand. The failure by any shareholder making a written demand to submit its certificates may result in the termination of the shareholder’s appraisal rights.
     The surviving corporation has 20 days after its receipt of a demand for payment to provide notice that the surviving corporation (i) accepts the amount claimed in the written demand and agrees to pay the amount claimed within 90 days from effective time of the merger, or (ii) offers to pay its estimated fair value of the shares within 90 days after the effective time.
     If, within 60 days after the effective time of the merger, the surviving corporation and a shareholder who has delivered written demand in accordance with Article 5.12 do not reach agreement as to the fair value of the shares, either the surviving corporation or the shareholder may file a petition in any Texas state court, with a copy served on the surviving corporation in the case of a petition filed by a shareholder, demanding a determination of the fair value of the shares held by all shareholders entitled to appraisal. The surviving corporation has no obligation and has no present intention to file such a petition if there are objecting shareholders. Accordingly, it is the obligation of MedSolutions’ shareholders to initiate all necessary action to perfect their appraisal rights in respect of shares of MedSolutions common stock within the time prescribed in Article 5.12. The failure of a shareholder to file such a petition within the period specified could nullify the shareholder’s previously written demand for appraisal.
     If a petition for appraisal is duly filed by a shareholder and a copy of the petition is delivered to the surviving corporation, the surviving corporation will then be obligated, within 10 days after receiving service of a copy of the petition, to provide the office of the clerk of the court in which the petition was filed with a list containing the names and addresses of all shareholders who have demanded an appraisal of their shares and with whom agreements as to the value of their shares have not been reached.
     After notice to dissenting shareholders, the court will conduct a hearing upon the petition, and determine those shareholders who have complied with Article 5.12 and who have become entitled to the appraisal rights provided thereby.
     After determination of the shareholders entitled to appraisal of their shares of MedSolutions common stock, the court will appraise the shares, determining their fair value. When the value is determined, the court will direct the payment of such value to the shareholders entitled to receive the same, immediately to the holders of uncertificated shares and upon surrender by holders of the certificates representing shares.

47


Table of Contents

     Pursuant to Article 5.12, the fair value of your shares is the value of such shares as of the day immediately preceding the date of the special meeting, excluding any appreciation or depreciation in anticipation of the merger. You should be aware that the fair value of your shares as determined under Article 5.12 could be more, the same, or less than the value that you are entitled to receive under the terms of the merger agreement.
     Costs of the appraisal proceeding may be imposed upon the surviving corporation and the shareholders participating in the appraisal proceeding by the court as the court deems equitable in the circumstances. Upon the application of a shareholder, the court may order all or a portion of the expenses incurred by any shareholder in connection with the appraisal proceeding, including, without limitation, reasonable attorneys’ fees and the fees and expenses of experts, to be charged pro rata against the value of all shares entitled to appraisal. Any shareholder who had demanded appraisal rights will not, after the effective time of the merger, be entitled to vote shares subject to that demand for any purpose or to receive payments of dividends or any other distribution with respect to those shares, other than with respect to payment as of a record date prior to the effective time; however, if no petition for appraisal is filed within 120 days after the effective time, or if the shareholder delivers a written withdrawal of such shareholder’s demand for appraisal and an acceptance of the terms of the merger prior to the filing of a petition for appraisal, then the right of that shareholder to appraisal will cease and that shareholder will be entitled to receive the cash and note consideration for shares of his, her or its MedSolutions common stock pursuant to the merger agreement. Any withdrawal of a demand for appraisal made after the filing of a petition for appraisal may only be made with the written approval of the surviving corporation.
     Failure to comply with all of the procedures set forth in Article 5.12 will result in the loss of a shareholder’s statutory appraisal rights. In view of the complexity of Article 5.12, MedSolutions’ shareholders who may wish to dissent from the merger and pursue appraisal rights should consult their legal advisors.
     If the number of shares of dissenting stock exceeds 7.5% of the outstanding shares of MedSolutions common stock outstanding immediately prior to the effective time of the merger, then Stericycle may elect not to consummate the merger.
Deregistration of MedSolutions Common Stock
     If the merger is completed, the shares of MedSolutions common stock will be deregistered under the Securities Exchange Act of 1934.

48


Table of Contents

INTERESTS OF MEDSOLUTIONS DIRECTORS AND EXECUTIVE OFFICERS IN THE MERGER
     In considering the recommendation of the MedSolutions Board of Directors with respect to the merger, MedSolutions shareholders should be aware that some directors and executive officers of MedSolutions have interests in the merger that are different from, or in addition to, the interests of MedSolutions shareholders generally. The MedSolutions Board of Directors was aware of those interests and took them into account in approving and adopting the merger agreement and recommending that MedSolutions shareholders vote to approve and adopt the merger agreement. Those interests are summarized below.
Stock Options
     All options to purchase MedSolutions common stock granted under MedSolutions’ equity compensation plans that are outstanding immediately prior to the effective time of the merger are fully vested. At the effective time of the merger, each outstanding MedSolutions stock option will be cancelled and converted into the right to receive the cash consideration and the note consideration in respect of the “in-the-money” value of the option. See “The Merger Agreement — Treatment of MedSolutions Options” beginning on page 55.
     The following table shows, as of October 8, 2007, the number of shares of MedSolutions common stock subject to vested and unexercised stock options held by MedSolutions’ named executive officers and directors.
                 
            Value of Stock
    Number of   Options
    Stock   (At $2.00 per share
Name and Principal Position   Options   net of exercise price)
Matthew H. Fleeger, President, Chief Executive Officer & Director
    0     $ 0.00  
Winship B. Moody, Sr., Chairman of the Board of Directors
    0     $ 0.00  
Ajit S. Brar, Director
    93,208     $ 110,510.00  
David L. Mack, Director
    62,222     $ 77,777.50  
Steven R. Block, Director
    0     $ 0.00  
Lonnie P. Cole, Sr., Senior Vice President—Sales
    0     $ 0.00  
J. Steven Evans, Vice President—Finance
    145,665     $ 178,998.25  
Alan E. Larosee, Vice President—Operations
    221,666     $ 273,332.50  
James M. Treat, Vice President—Business Development
    173,333     $ 216,666.25  
Mark M. Altenau, Former Director in 2006
    69,833     $ 77,166.25  
Severance Payments
     Pursuant to the merger agreement, all employment agreements entered into between MedSolutions and its employees, including its executive officers, will be terminated at or prior to closing, and such employees will be paid all severance benefits payable in connection with such terminations. The following table sets forth the lump sum cash payments that MedSolutions’ named executive officers will receive if the merger is consummated.
         
    Cash Severance
Executive Officer   Payments
Matthew H. Fleeger
  $ 600,000.00  
Lonnie P. Cole, Sr.
  $ 100,000.00  
J. Steven Evans
  $ 109,000.00  
Alan E. Larosee
  $ 109,537.50  
James M. Treat
  $ 111,300.00  

49


Table of Contents

Positions of Certain MedSolutions Executive Officers After the Merger
     Stericycle intends to retain, pursuant to a letter agreement to be executed in connection with the closing of the merger, Matthew H. Fleeger, MedSolutions’ President and Chief Executive Officer, or a company affiliated with Mr. Fleeger as a consultant for a period of six months beginning on the closing date of the merger to provide transition management and other services. Mr. Fleeger or his affiliated company will receive aggregate consulting fees of $96,900 for such services as well as health insurance coverage for Mr. Fleeger and his dependents. Subject to landlord approval, Stericycle also intends to sublease MedSolutions’ current corporate office space to Mr. Fleeger beginning on the six-month anniversary of the closing date of the merger, at the rental rates and for the remaining term as specified in MedSolutions’ current office lease.
     Stericycle may also retain additional officers or employees of MedSolutions to provide transitional services on a consulting basis after the closing of the merger.
Ownership of MedSolutions Common Stock
     MedSolutions’ directors and executive officers and their affiliates beneficially owned, as of the record date, approximately 13.6% of the outstanding MedSolutions common stock, including those shares of MedSolutions common stock underlying outstanding stock options and convertible debt.

50


Table of Contents

MATERIAL UNITED STATES FEDERAL INCOME TAX CONSEQUENCES
     The following discussion summarizes certain material U.S. federal income tax consequences of the merger to U.S. holders. This discussion is based upon the Internal Revenue Code of 1986, as amended, Treasury Regulations promulgated under the Internal Revenue Code, court decisions, published positions of the Internal Revenue Service and other applicable authorities, all as in effect on the date of this document and all of which are subject to change or differing interpretations, possibly with retroactive effect. This discussion is limited to U.S. holders who hold MedSolutions shares as capital assets for U.S. federal income tax purposes (generally, assets held for investment). This discussion does not address all of the U.S. federal income tax consequences that may be relevant to holders in light of their particular circumstances or to holders who may be subject to special treatment under U.S. federal income tax laws, such as tax exempt organizations, foreign persons or entities, S corporations or other pass-through entities, financial institutions, insurance companies, broker-dealers, holders who hold MedSolutions shares as part of a hedge, straddle, wash sale, synthetic security, conversion transaction, or other integrated investment comprised of MedSolutions shares and one or more investments, holders with a “functional currency” (as defined in the Internal Revenue Code) other than the U.S. dollar, persons who exercise appraisal rights, and persons who acquired MedSolutions shares in compensatory transactions. Further, this discussion does not address any aspect of state, local or foreign taxation. No ruling has been or will be obtained from the Internal Revenue Service regarding any matter relating to the merger. No assurance can be given that the Internal Revenue Service will not assert, or that a court will not sustain, a position contrary to any of the tax aspects described below. Holders are urged to consult their own tax advisors as to the U.S. federal income tax consequences of the merger, as well as the effects of state, local and foreign tax laws.
     As used in this summary, a “U.S. holder” includes:
    an individual U.S. citizen or resident alien;
 
    a corporation, partnership or other entity created or organized under U.S. law (federal or state);
 
    an estate whose worldwide income is subject to U.S. federal income tax; or
 
    a trust if a court within the United States of America is able to exercise primary supervision over the administration of the trust and one or more U.S. persons have the authority to control all substantial decisions of the trust.
     If a partnership (including for this purpose any entity treated as a partnership for U.S. federal income tax purposes) is a beneficial owner of MedSolutions shares, the tax treatment of a partner in that partnership will generally depend on the status of the partner and the activities of the partnership. Holders of MedSolutions shares that are partnerships and partners in these partnerships are urged to consult their tax advisors regarding the U.S. federal income tax consequences of owning and disposing of MedSolutions shares in the merger.
     THIS SUMMARY IS NOT A SUBSTITUTE FOR AN INDIVIDUAL ANALYSIS OF THE TAX CONSEQUENCES OF THE MERGER TO YOU. WE URGE YOU TO CONSULT A TAX ADVISOR REGARDING THE PARTICULAR FEDERAL, STATE, LOCAL AND FOREIGN TAX CONSEQUENCES OF THE MERGER IN LIGHT OF YOUR OWN SITUATION.
     This summary of certain material U.S. federal income tax considerations, and any other discussion in this proxy statement/prospectus of the tax consequences or tax risks of the merger to U.S. holders of MedSolutions common stock (collectively, “written discussion”) is not intended nor written to be used, and cannot be used, by any person for the purpose of avoiding tax penalties that may be imposed on such person. The written discussion was prepared to support the marketing of the transaction(s) or matter(s) addressed by such written discussion, and the taxpayer should seek advice based on the taxpayer’s particular circumstances from an independent tax advisor.

51


Table of Contents

Tax Consequences of the Merger to U.S. Holders of MedSolutions Common Stock
The Merger
     The receipt of the merger consideration in the merger will result in a taxable transaction for United States federal income purposes and also may result in a taxable transaction under applicable state, local and other income tax laws. In general, under Section 1001 of the Internal Revenue Code of 1986, as amended (the “Code”), a holder of MedSolutions common stock will recognize gain or (subject to the limitations under Section 267 of the Code) loss equal to the difference between his or her adjusted tax basis in the MedSolutions common stock surrendered as determined under Section 1011 of the Code and the fair market value of the cash and promissory notes received, if any.
     If a MedSolutions shareholder effectively dissents from the merger and receives cash for his, her or its shares, such cash will be treated as having been received by that shareholder as a distribution in redemption of his, her or its MedSolutions common stock, subject to the provisions and limitations of Section 302 of the Code, which determines whether a distribution in redemption of stock is treated as a payment in exchange for the stock or as a dividend. Where as a result of such distribution, a shareholder owns no MedSolutions common stock, either directly or through the application of Section 318(a) of the Code, the redemption will be a complete termination of interest within the meaning of Section 302(b)(3) of the Code and such cash will be treated as a distribution in full payment in exchange for his or her MedSolutions common stock, and not as a dividend.
     Assuming that the shares of MedSolutions common stock have been held as a capital asset, the gain or loss recognized by a MedSolutions shareholder generally will constitute a capital gain or loss, other than, with respect to the exercise of dissenters’ rights, amounts, if any, which are treated as a dividend under Section 302 of the Code (and taxable as such), or which constitute interest or are deemed to constitute interest for federal income tax purposes (which amounts will be taxable as ordinary income). The gain will constitute short-term capital gain or loss subject to ordinary income tax rates if, at the effective time of the merger, the shares of MedSolutions common stock were held for one year or less. If the shares were held for more than one year, the capital gain or loss would be long-term, subject in the case of individual shareholders, estates and certain trusts to tax at a maximum United States federal income tax rate of 15% for 2007.
     With certain exceptions, installment sale treatment under Section 453 of the Code may be available for purposes of reporting gain attributable to the promissory note portion of the merger consideration received pursuant to the Merger. The installment method permits gain (but not loss) from installment sales to be taxed as the shareholder receives installment payments instead of being taxed in full in the year of the merger.
     A shareholder may elect out of installment sale treatment. If a shareholder makes such an election, taxable gain will be recognized to the same extent as if the shareholder’s shares had been exchanged for cash in the amount of the face value of the promissory note.
     The benefits of the installment method of reporting gain on installment sales are limited by a number of statutory rules including the following: (i) the pledge of certain installment obligations is treated as a payment resulting in the recognition of gain; (ii) a disposition of an installment obligation generally triggers the recognition of any deferred gain remaining on the sale; and (iii) the installment method is generally not available in respect of dispositions by dealers. Furthermore, where the installment method does apply, a special interest rule applicable to an installment obligation arising from a disposition of property with a sales price in excess of $150,000 may apply, with the possible effect of diminishing or eliminating the economic benefit of the deferral.

52


Table of Contents

     If the Internal Revenue Service were to successfully assert that the promissory notes do not qualify for installment treatment, then MedSolutions shareholders would not be able to defer the recognition of a portion of their gain during the term of the promissory notes. Taxpayers are urged to consult their own independent tax advisors to consider the possible effects of installment reporting of gain allocated to the promissory note portion of the payments received pursuant to the merger, and the possible effects of electing out of the installment method.
     Because the stated interest rate payable on the promissory notes is less than the relevant applicable federal rate (“AFR”), additional interest under the promissory notes will be imputed by reason of the imputed interest rules of Sections 1274 or 483 of the Code, as applicable. The relevant AFR is calculated by determining the appropriate term of the debt instrument (short-, mid- or long-term) and applying the lowest AFR during the three-month periods ending with the month in which the merger agreement was signed and the month in which the merger occurs. The promissory notes will be considered mid-term debt for these purposes. The lowest AFR for mid-term debt during May, June and July, 2007 was 4.62%.
     The imputed interest rules will have the effect of re-characterizing as interest, for federal income tax purposes, a portion of the principal to be paid on the promissory notes because the relevant AFR exceeds the nominal interest of 4.5% or 3.5% payable on the promissory notes. You are urged to consult your own tax advisor to determine how the imputed interest rules will affect you.
Backup Withholding
     United States federal income tax law requires that a holder of MedSolutions shares provide the payment agent with his or her correct taxpayer identification number, which is, in the case of a U.S. holder who is an individual, a social security number, or, in the alternative, establish a basis for exemption from backup withholding. Exempt holders, including, among others, corporations and some foreign individuals, are not subject to backup withholding and reporting requirements. If the correct taxpayer identification number or an adequate basis for exemption is not provided, a holder will be subject to backup withholding on any reportable payment. Any amounts withheld under the backup withholding rules from a payment to a U.S. holder will be allowed as a credit against that U.S. holder’s U.S. federal income tax and may entitle the U.S. holder to a refund, if the required information is furnished to the Internal Revenue Service.
     To prevent backup withholding, each holder of MedSolutions shares must complete the Substitute Form W-9 which will be provided by the payment agent with the transmittal letter and certify under penalties of perjury that:
    the taxpayer identification number provided is correct or that the holder is awaiting a taxpayer identification number, and
 
    the holder is not subject to backup withholding because
    the holder is exempt from backup withholding,
 
    the holder has not been notified by the Internal Revenue Service that he is subject to backup withholding as a result of the failure to report all interest or dividends, or
 
    the Internal Revenue Service has notified the holder that he is no longer subject to backup withholding.
     The Substitute Form W-9 must be completed, signed and returned to the payment agent.

53


Table of Contents

THE MERGER AGREEMENT
     The following summary of the merger agreement is qualified by reference to the complete text of the merger agreement, which is attached as Annex A and incorporated by reference into this proxy statement/prospectus.
     The merger agreement contains representations and warranties Stericycle and MedSolutions made to each other. The assertions embodied in MedSolutions’ representations and warranties are qualified by information in confidential disclosure schedule that MedSolutions has provided to Stericycle in connection with signing the merger agreement. The disclosure schedule contain information that modifies, qualifies and creates exceptions to MedSolutions’ representations and warranties set forth in the attached merger agreement. Accordingly, you should keep in mind that MedSolutions’ representations and warranties are modified in important part by the underlying disclosure schedule. The disclosure schedule contains information that has been included in MedSolutions’ general prior public disclosures, as well as additional information, some of which is non-public. Neither Stericycle nor MedSolutions believe that MedSolutions’ disclosure schedule contains information that the securities laws require them to publicly disclose except as discussed in this proxy statement/prospectus. Moreover, information concerning the subject matter of the representations and warranties may have changed since the date of the merger agreement, and that information may or may not be fully reflected in the companies’ public disclosures.
Structure of the Merger
     Upon the terms and subject to the conditions of the merger agreement, and in accordance with the TBCA, at the effective time of the merger, TMW Acquisition Corporation, a wholly-owned subsidiary of Stericycle, which we refer to as Merger Sub, will be merged with and into MedSolutions. MedSolutions will continue as the surviving corporation and a wholly-owned subsidiary of Stericycle. The separate corporate existence of Merger Sub will cease. The effectiveness of the merger will not affect the separate corporate existence of MedSolutions’ subsidiaries, which will remain subsidiaries of MedSolutions following the merger.
Timing of Closing
     The closing date of the merger will occur as soon as possible following the date on which all conditions to the merger, other than those conditions that by their nature are to be satisfied at the closing, have been satisfied or waived. Stericycle and MedSolutions expect to complete the merger during the fourth quarter of 2007. However, we do not know how long after the MedSolutions special meeting the closing of the merger will take place. Stericycle and MedSolutions hope to have the significant conditions satisfied so that the closing can occur immediately following the special meeting. However, there can be no assurance that such timing will occur or that the merger will be completed during the fourth quarter of 2007 as expected.
     As soon as practicable after the closing of the merger, Merger Sub and MedSolutions will file a certificate of merger with the Secretary of State of the State of Texas. The effective time of the merger will be the time Merger Sub and MedSolutions file the certificate of merger with the Secretary of State of the State of Texas or at a later time as we may agree and specify in the certificate of merger.
Merger Consideration
     At the effective time of the merger, each outstanding share of MedSolutions common stock (other than any shares owned directly or indirectly by MedSolutions, Stericycle or Merger Sub and those shares

54


Table of Contents

held by dissenting shareholders) will be converted into the right to receive $0.50 in cash, without interest, and a promissory note in the principal amount of $1.50. We refer to the aggregate amount of the cash consideration and the note consideration to be received by MedSolutions shareholders pursuant to the merger as the merger consideration. The aggregate merger consideration is subject to adjustment after the closing of the merger in certain events. See “The Merger Agreement — Adjustments to Merger Consideration” beginning on page 59 of this proxy statement/prospectus. At the closing of the merger, $125,000 of the aggregate cash consideration will be placed into an escrow account for use by the shareholder representative for the costs and expenses of fulfilling its duties under the merger agreement. See “The Merger Agreement — Shareholder Representative” beginning on page 62 of this proxy statement/prospectus.
     The promissory notes will be payable in seven installments of interest only due on each of the first six anniversaries of the date on which the merger closes and one final installment of principal and interest due on the seventh anniversary of such closing date, and will bear interest, at the election of each holder of shares of MedSolutions common stock, at the annual rate of either 3.5% (if such shareholder elects to have such promissory note supported by a master letter of credit) or 4.5% (if such shareholder does not elect such support). Holders of the promissory notes will not have any voting rights with respect to Stericycle. See “Description of Promissory Notes” beginning on page 71 of this proxy statement/prospectus.
     The promissory notes will be subject to payment offset and reduction and principal reduction pursuant to the merger consideration adjustment, litigation payment adjustment and indemnification provisions of the merger agreement or in the event that the expenses of the payment agent and the indenture trustee exceed $80,000. See “The Merger Agreement — Payment Procedures,” “The Merger Agreement — Representations and Warranties and Indemnification,” and “The Merger Agreement — Adjustments to Merger Consideration — Application of Closing Balance Sheet and Revenue Adjustments” and “ — Litigation Adjustment” beginning on pages 56, 57 and 61 of this proxy statement/prospectus, respectively.
Treatment of MedSolutions Options
     All MedSolutions stock options have vested. At the effective time of the merger, the MedSolutions stock options will be canceled and converted to a right to receive the merger consideration for each deemed outstanding MedSolutions option share. The number of deemed outstanding MedSolutions option shares attributable to each MedSolutions stock option will be equal to the net number of shares of MedSolutions common stock (rounded down to the next whole share) that would have been issued upon a cashless exercise of that MedSolutions stock option immediately before the effective time of the merger. That net number of shares will be computed by deducting from the shares of MedSolutions common stock that would be issued to the option holder a number of deemed surrendered shares of MedSolutions common stock which is equal to the fair value of (i) the exercise price of a MedSolutions stock option to be paid by the option holder and (ii) all amounts required to be withheld and paid by MedSolutions for federal taxes and other payroll withholding obligations as a result of such exercise (using an assumed tax rate of 35%). The fair value of each deemed surrendered share of MedSolutions common stock, for purposes of determining the net number of shares, will be equal to $2.00.
Conversion of Shares
     At the effective time of the merger, each outstanding share of MedSolutions common stock (other than shares held by MedSolutions, Stericycle or Merger Sub and shareholders who properly exercise their dissenters’ rights) will automatically be canceled and retired, will cease to exist and will be converted into

55


Table of Contents

the right to receive the merger consideration. Shares of MedSolutions common stock owned by MedSolutions will be canceled in the merger without payment of any merger consideration.
     Prior to the completion of the merger, Stericycle will deposit with the payment agent, for the benefit of the holders of MedSolutions common stock and stock options to purchase MedSolutions common stock, an amount in cash and promissory notes sufficient to effect the conversion of MedSolutions common stock and exercised stock options into the cash and note consideration to be paid in the merger. Stericycle has appointed LaSalle Bank National Association, Chicago, Illinois to act as payment agent for the merger.
Payment Procedures
     As soon as reasonably practicable after the effective time of the merger, the payment agent will send to each holder of MedSolutions common stock a letter of transmittal for use in the payment of the merger consideration and instructions explaining how to surrender MedSolutions shares to the payment agent. Holders of MedSolutions common stock who surrender their certificates to the payment agent, together with a properly completed letter of transmittal, will receive the appropriate merger consideration.
     At the effective time of the merger, the stock transfer books of MedSolutions will be closed and no further issuances or transfers of MedSolutions common stock will be made. If, after the effective time, valid MedSolutions stock certificates are presented to the surviving corporation for any reason, they will be cancelled and exchanged as described above to the extent allowed by applicable law.
     The payment agent will deliver to MedSolutions, as the surviving corporation, any promissory notes to be issued in the merger and any funds set aside by Stericycle to pay the cash consideration that are not claimed by former MedSolutions shareholders within six months after the effective time of the merger. Thereafter, the surviving corporation will act as the payment agent and former MedSolutions shareholders may look only to the surviving corporation for payment of their merger consideration, provided that the payment agent will continue to disburse payments due under the promissory notes that have been duly issued to holders of MedSolutions common stock. None of MedSolutions, Stericycle, the surviving corporation, the payment agent or any other person will be liable to any former MedSolutions shareholder for any amount properly delivered to a public official pursuant to applicable abandoned property, escheat or similar laws.
     Stericycle will pay for the expenses of the payment agent and the indenture trustee incurred in connection with the payment of the merger consideration in an aggregate amount up to $80,000. Any reasonable expenses of the payment agent in excess of $80,000 will be paid by Stericycle and reimbursed by reducing the principal amount of the promissory notes by the amount of such expenses on a pro rata basis. Any such principal reduction is referred to in this proxy statement/prospectus as an “expense payment principal reduction.”
     MEDSOLUTIONS STOCK CERTIFICATES SHOULD NOT BE RETURNED WITH THE ENCLOSED PROXY CARD. MEDSOLUTIONS STOCK CERTIFICATES SHOULD BE RETURNED WITH THE TRANSMITTAL LETTER AND ACCOMPANYING INSTRUCTIONS WHICH WILL BE PROVIDED TO MEDSOLUTIONS SHAREHOLDERS BY THE PAYMENT AGENT FOLLOWING THE EFFECTIVE TIME OF THE MERGER.

56


Table of Contents

Directors and Officers of the Surviving Corporation After the Merger
     Under the merger agreement, the directors and officers of Merger Sub immediately prior to the effective time of the merger will be the directors and officers of the surviving corporation at and after the effective time of the merger.
Representations and Warranties and Indemnification
     The merger agreement contains customary and substantially reciprocal representations and warranties made by each party to the other. MedSolutions’ representations and warranties to Stericycle and Merger Sub relate to, among other things:
    corporate organization, qualification and good standing;
 
    corporate power and authority to enter into the merger agreement, and due execution, delivery and enforceability of the merger agreement;
 
    the ownership of equity interests in other entities, including the ownership of the equity interests of MedSolutions’ subsidiaries;
 
    the absence of proxies or voting agreements with respect to the stock of our subsidiaries and the absence of any option, warrant or other commitment obligating MedSolutions or any of its subsidiaries to issue, sell, redeem or repurchase any equity interest in any of our subsidiaries;
 
    the participation by MedSolutions and its subsidiaries in joint ventures;
 
    absence of a breach of charter documents, bylaws, material agreements, instruments or obligations, or applicable law as a result of the merger;
 
    consents, approvals, orders, authorizations, registrations, declarations, filings and permits required to enter into the merger agreement or to complete the transactions contemplated by the merger agreement;
 
    timely and accurate filings with the Securities and Exchange Commission in compliance with applicable rules and regulations;
 
    financial statements;
 
    capital structure;
 
    list of MedSolutions’ equipment;
 
    MedSolutions’ real property and real property leases;
 
    absence of undisclosed liabilities;
 
    absence of specified adverse changes or events since January 1, 2007;
 
    material contracts;
 
    compliance with laws, material agreements and permits;
 
    governmental regulation;
 
    material litigation, material judgments or injunctions and absence of undisclosed investigations or litigation;
 
    absence of certain restrictive agreements or arrangements;
 
    tax matters;

57


Table of Contents

    the amount of MedSolutions’ net operating loss for federal tax purposes as of December 31, 2006;
 
    employee benefit plans and labor matters;
 
    employee contracts and benefits;
 
    insurance matters;
 
    intellectual property;
 
    title to assets;
 
    environmental matters;
 
    brokers and finders’ fees;
 
    required vote of MedSolutions shareholders to approve the merger;
 
    recommendation of MedSolutions’ Board of Directors;
 
    absence of preferential purchase or repurchase rights;
 
    inapplicability of Texas anti-takeover statute;
 
    accuracy of information provided for inclusion in this proxy statement/prospectus.
     The representations and warranties in the merger agreement are subject to materiality and knowledge qualifications in many respects and survive the closing of the merger agreement until the first anniversary of the closing date of the merger, with the exception of MedSolutions’ representations and warranties relating to environmental and tax matters, which will survive the closing and continue until the date that is 90 days after the expiration of the underlying statutes of limitations for such matters.
     Pursuant to the merger agreement, Stericycle may assert an indemnification claim for any loss, damage, cost or expense (including reasonable attorneys’ fees) that is caused by, arises out of or relates to any breach of any representation and warranty by MedSolutions in the merger agreement or in the officer’s certificate to be delivered by MedSolutions to Stericycle at closing. Any such indemnification claim must be asserted prior to the expiration of the representation or warranty in question. Except in certain limited instances, Stericycle may not assert an indemnification claim until the aggregate amount for which indemnification is sought exceeds $100,000, and if such threshold is reached, may then assert its claim only for the portion of the indemnification claim in excess of $100,000. Any subsequent indemnification claims after the $100,000 threshold is met are not subject to any further thresholds.
     Stericycle may assert an indemnification claim by providing written notice to the shareholder representative. If the shareholder representative does not object to an indemnification claim within 30 days of its receipt of such written notice, Stericycle’s indemnification claim will be considered undisputed. If the shareholder representative gives written notice to Stericycle within such 30-day period that the shareholder representative objects to Stericycle’s indemnification claim, Stericycle and the shareholder representative will attempt in good faith to resolve their differences. If Stericycle and the shareholder representative fail to resolve their disagreement within 30 days of the date on which Stericycle receives notice of the shareholder representative’s objection, either party may submit the disputed indemnification claim for binding arbitration before the American Arbitration Association in Chicago, Illinois or Dallas, Texas.
     To the extent that any indemnification claim by Stericycle is undisputed or is resolved in Stericycle’s favor, either by agreement with the shareholder representative or by binding arbitration, the

58


Table of Contents

indemnification claim will reduce the aggregate amounts next becoming due under the promissory notes on a pro rata basis. This reduction will be Stericycle’s sole means of satisfying an indemnification claim. Any such reduction is referred to in this proxy statement/prospectus as an “indemnification claim payment reduction.”
Adjustments to Merger Consideration
Closing Balance Sheet Adjustment
     Pursuant to the merger agreement, following the closing of the merger, Stericycle and the shareholder representative will determine MedSolutions’ adjusted liabilities (as defined below) and adjusted current assets (as defined below), in each case as of the date of the closing. If the excess of MedSolutions’ adjusted liabilities over its adjusted current assets as of the closing date (the “liability excess”) is less than $4,340,000 (including no more than $90,000 in capital expenditures since May 31, 2007), the aggregate merger consideration will be increased by an amount equal to the difference between $4,340,000 and the liability excess. If the liability excess as of the closing date is more than $4,340,000, the aggregate merger consideration will be reduced by an amount equal to the difference between the liability excess and $4,340,000. The $4,340,000 threshold referred to in the preceding two sentences will be reduced, however, on a dollar-for-dollar basis to the extent that the sum of the aggregate merger consideration payable with respect to shares of MedSolutions common stock and merger consideration and tax withholdings with respect to the exercise of stock options to purchase MedSolutions common stock in connection with the merger exceeds $54,350,000. Any adjustment will be applied as described under the heading “— Application of Adjustments” below. This adjustment is referred to in this proxy statement/prospectus as the “closing balance sheet adjustment.”
     “Adjusted liabilities” means MedSolutions’ consolidated total liabilities determined in accordance with United States generally accepted accounting principles (“GAAP”), as increased by (except to the extent already accrued) (i) severance payments and other termination liabilities under employment agreements with MedSolutions’ employees or otherwise, (ii) MedSolutions’ unpaid transaction expenses relating to the merger, and as reduced by the first $100,000 of MedSolutions’ unpaid transaction expenses relating to the merger. “Adjusted current assets” means MedSolutions’ total current assets as determined in accordance with GAAP.
     Stericycle will prepare a schedule of adjusted liabilities and adjusted current assets as of the closing date within 75 days after the closing, and will promptly furnish a copy of such schedule to the shareholder representative. If the shareholder representative accepts Stericycle’s schedule, or if the shareholder representative fails to give written notice to Stericycle of any objection within 30 days after receipt of a copy of such schedule, Stericycle’s schedule will become binding. If the shareholder representative gives written notice to Stericycle within such 30-day period that the shareholder representative objects to Stericycle’s schedule of adjusted liabilities and adjusted current assets, Stericycle and the shareholder representative will attempt in good faith to resolve their differences. If Stericycle and the shareholder representative fail to resolve their disagreement within 30 days of the date on which Stericycle receives notice of the shareholder representative’s objection, either party may submit the disputed items to a mutually acceptable accounting firm for a determination of the correct amounts, which determination will be binding on Stericycle and the shareholder representative. If Stericycle and the shareholder representative are unable to agree upon a mutually acceptable accounting firm within 10 days of the date on which both parties become aware of such dispute, Stericycle will select an accounting firm that is not Stericycle’s regular accounting firm, the shareholder representative will select an accounting firm that was not the regular accounting firm of MedSolutions, and the two firms so selected will select a third accounting firm that is not the regular accounting firm of either Stericycle or MedSolutions to resolve the disputed items.

59


Table of Contents

Revenue Adjustment
     Pursuant to the merger agreement, following the closing of the merger Stericycle and the shareholder representative will determine MedSolutions’ measured revenues (as defined below). If the measured revenues are $16,000,000 or more, there will be no adjustment to the aggregate merger consideration. If the measured revenues are less than $16,000,000, the aggregate merger consideration will be reduced by an amount equal to the difference between the product of (i) $16,000,000 less the amount of measured revenues multiplied by (ii) 3.375. Any adjustment will be applied as described under the heading “— Application of Adjustments” below. This adjustment is referred to in this proxy statement/prospectus as the “revenue adjustment.”
     “Measured revenues” means the sum of $15,655,352 plus the aggregate annualized gross revenues (net of returns, rebates and chargebacks) received by MedSolutions from certain scheduled customers during the first three full calendar months after the closing. Such net revenues will be annualized on a customer-by-customer basis as follows: (i) if there are three full calendar months of service to such customer during the measurement period, the net revenues will be annualized by multiplying them by four; (ii) if there are only two full calendar months of service to such customer during the measurement period, the net revenues will be annualized by multiplying them by six; (iii) if there is only one full calendar month of service to such customer during the measurement period, the net revenues will be annualized by multiplying them by 12; and (iv) if there is less than one full calendar month of service, the average weekly net revenues for such month will be annualized by multiplying them by 52.
     Stericycle will prepare a schedule of measured revenues within 45 days after the end of the three full calendar month measurement period described above, and will promptly furnish a copy of such schedule to the shareholder representative. If the shareholder representative accepts Stericycle’s schedule, or if the shareholder representative fails to give written notice to Stericycle of any objection within 30 days after receipt of a copy of such schedule, Stericycle’s schedule will become binding. If the shareholder representative gives written notice to Stericycle within such 30-day period that the shareholder representative objects to Stericycle’s schedule of measured revenues, Stericycle and the shareholder representative will attempt in good faith to resolve their differences. If Stericycle and the shareholder representative fail to resolve their disagreement within 30 days of the date on which Stericycle receives notice of the shareholder representative’s objection, either party may submit the disputed items to a mutually acceptable accounting firm for a determination of the correct amounts, which determination will be binding on Stericycle and the shareholder representative. If Stericycle and the shareholder representative are unable to agree upon a mutually acceptable accounting firm within 10 days of the date on which both parties become aware of such dispute, Stericycle will select an accounting firm that is not Stericycle’s regular accounting firm, the shareholder representative will select an accounting firm that was not the regular accounting firm of MedSolutions, and the two firms so selected will select a third accounting firm that is not the regular accounting firm of either Stericycle or MedSolutions to resolve the disputed items.
Application of Closing Balance Sheet and Revenue Adjustments
     When both the closing balance sheet adjustment and revenue adjustment have been finally determined as described above, the aggregate merger consideration will be adjusted as follows:
    If there is an increase in the aggregate merger consideration due to the closing balance sheet adjustment and no adjustment pursuant to the revenue adjustment, Stericycle will, within three days of such determination, deposit cash equal to the increase in the aggregate merger consideration with the payment agent for distribution on a pro rata basis to holders of

60


Table of Contents

      MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates for payment and holders of MedSolutions options;
 
    If there is an increase in the aggregate merger consideration due to the closing balance sheet adjustment and a reduction in the aggregate merger consideration pursuant to the revenue adjustment, the two amounts will be added together to determine the net adjustment to the aggregate merger consideration, and
    if the net adjustment is an increase in the aggregate merger consideration, Stericycle will, within three days of such determination, deposit cash equal to the increase in the aggregate merger consideration with the payment agent for distribution on a pro rata basis to holders of MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates for payment and holders of MedSolutions option; or
 
    if the net adjustment is a reduction in the aggregate merger consideration, the principal amounts of the promissory notes will be reduced, retroactive to the closing date, on a pro rata basis in an aggregate amount equal to the reduction in the aggregate merger consideration; and
    If there is a reduction in the aggregate merger consideration due to both the closing balance sheet adjustment and the revenue adjustment, the two amounts shall be added together to determine the combined reduction in the aggregate merger consideration, and the principal amounts of the promissory notes will be reduced, retroactive to the closing date, on a pro rata basis in an aggregate amount equal to the reduction in the aggregate merger consideration.
     Any such reduction in the principal amount of the promissory notes is referred to in this proxy statement/prospectus as a “merger consideration principal reduction.”
Litigation Adjustment
     On May 14, 2007, a Texas jury found EnviroClean Management Services, Inc., a Texas corporation and a subsidiary of MedSolutions (“EMSI”), liable in connection for approximately $10.4 million in actual damages and $10 million in punitive damages in connection with a 2004 traffic accident involving one of EMSI’s trucks. On June 15, 2007, a judgment was entered in the amount of $15,005,245. On September 27, 2007, counsel for the parties to the lawsuit and EMSI’s insurance providers entered into a preliminary but binding agreement with respect to the material terms of the settlement of the lawsuit pursuant to Rule 11 of the Texas Rules of Civil Procedure. The material terms of the settlement provide for a cash payment by EMSI’s insurance providers to the plaintiff, and also requires EMSI to deliver an interest-free promissory note in the principal amount of $250,000 (the “settlement note”) to the plaintiff. The settlement note is only payable in the event that the merger closes, and will be due on the date that the principal amount of the promissory notes issuable by Stericycle to MedSolutions’ shareholders becomes payable (i.e., on the seventh anniversary of the effective time of the merger). Any funds as of such date remaining from the $125,000 to be placed in the shareholder representative escrow account will be remitted by the shareholder representative to the surviving corporation, which will apply such funds towards the amount due under the settlement note. The principal amount of the promissory notes will be reduced on a pro rata basis in an aggregate amount equal to the difference between $250,000 (the principal amount of the settlement note) and the amount remitted to the surviving corporation from the shareholder representative escrow account. The preliminary but binding agreement under Rule 11 of the Texas Rules of Civil Procedure contains the essential terms of the settlement that will be supplemented by a more thorough agreement containing appropriate releases and documentation of other terms consistent with such essential terms.

61


Table of Contents

     Any such reduction in the principal amount of the promissory notes is referred to in this proxy statement/prospectus as a “litigation payment principal reduction.”
Shareholder Representative
     Pursuant to the merger agreement, at the effective time of the merger Matthew H. Fleeger and Winship B. Moody, Sr. will be appointed as the joint agents and attorneys-in-fact, for the holders of shares of MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates to the payment agent, to give and receive notices and communications and to take any and all

62


Table of Contents

action on behalf of such holders pursuant to the merger agreement and in connection with the promissory notes, including without limitation asserting, prosecuting, or settling any claim against the surviving corporation or Stericycle or defending or settling any claim asserted by the surviving corporation or Stericycle. In this capacity, Mr. Fleeger and Mr. Moody are referred to as the “shareholder representative” in this proxy statement/prospectus. The shareholder representative may be changed from time to time by the consent of holders representing a majority of the shares of MedSolutions common stock immediately prior to the effective time of the merger upon written notice to the surviving corporation and the shareholder representative. Any vacancy in the position of shareholder representative may be filled by the remaining shareholder representative, if any, subject to the rights of holders representing a majority of the shares of MedSolutions common stock immediately prior to the effective time of the merger to replace any shareholder representative so appointed. Any notices or communications to or from the shareholder representative will constitute notice to or from each of the holders of shares of MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates to the payment agent. Any decision, act, consent or instruction of the shareholder representative (acting in such capacity) will constitute a decision of all of the holders of shares of MedSolutions common stock who have duly surrendered or may duly surrender their stock certificates to the payment agent, and will be final, binding and conclusive upon each such holder. The surviving corporation and Stericycle are authorized to rely upon any such decision, act, consent or instruction of the shareholder representative as being the decision, act, consent or instruction of each such holder. No bond is being required of the shareholder representative, and by voting to approve and adopt the merger agreement each holder of MedSolutions common stock agrees that the shareholder representative will not be liable to such holder or any other person for any action taken, or declined to be taken, in good faith and in the exercise of reasonable judgment.
     At closing of the merger, Stericycle will place $125,000 of the aggregate merger consideration into an escrow account with Park Cities Bank, Dallas, Texas, which amount will be made available for use by the shareholder representative for the costs and expenses incurred by the shareholder representative in fulfilling its duties under the merger agreement. Such costs and expenses will include $5,000 per year compensation paid to each of Messrs. Fleeger and Moody for their service as shareholder representative. The $125,000 will be deducted on a pro rata basis from the cash consideration distributable to the holders of shares of MedSolutions common stock in connection with the merger. Any funds remaining in such escrow account on the date of the last payment payable under the promissory notes will be remitted to the surviving corporation to be applied towards the $250,000 payment due with respect to the litigation settlement described in “The Merger Agreement — Litigation Adjustment” on page 61 of this proxy statement/prospectus.
Covenants and Agreements
     Each of Stericycle and MedSolutions has undertaken various covenants in the merger agreement. The following summarizes the more significant of these covenants:
Operating Covenants — MedSolutions
     Prior to the effective time of the merger MedSolutions has agreed that it and its subsidiaries will conduct their operations in the ordinary course consistent with past practices. Prior to the effective time of the merger, unless Stericycle consents otherwise in writing, with certain exceptions, MedSolutions has agreed that neither MedSolutions nor any of its subsidiaries will:
    sell, lease, transfer or dispose of any of its assets used, held for use or useful in conduct of MedSolutions’ medical waste business except in the ordinary course consistent with past practices;

63


Table of Contents

    enter into any contract, other than any contracts relating to the merger, relating to MedSolutions’ medical waste business except in the ordinary course consistent with past practices;
 
    terminate, accelerate or modify any material contract relating to MedSolutions’ medical waste business to which it is or was a party or by which it is or was bound, or agree to do so, except in the case of contracts that expire in accordance with their terms or that terminate in the ordinary course consistent with past practices;
 
    impose or permit any lien (other than liens permitted under the merger agreement) on any of its assets except in the ordinary course consistent with past practices;
 
    delay or postpone beyond its normal practice payment of its vendor accounts payable and other liabilities;
 
    cancel, compromise, waive or release any claim or right outside of the ordinary course consistent with past practices;
 
    experience any damage, destruction or loss to any material portion of its assets used, held for use or useful in conduct of MedSolutions’ medical waste business (whether or not covered by insurance);
 
    change the base compensation or other terms of employment of any of its employees except in the ordinary course consistent with past practices;
 
    pay a bonus to any employee;
 
    adopt a new employee benefit plan, terminate any existing plan or increase the benefits under or otherwise modify any existing plan except as contemplated by the merger agreement;
 
    amend its organizational documents;
 
    issue, sell, redeem or repurchase, or effect any split, combination or reclassification of, any shares of its capital stock or other securities or retire any indebtedness;
 
    grant any stock options;
 
    declare or pay any dividends or make any other distributions in respect of its capital stock;
 
    make, or guarantee, any loans or advances to another person, other than MedSolutions or one of its subsidiaries, or make any investment or commitment to invest in any person other than MedSolutions or one of its subsidiaries;
 
    make any capital expenditures in excess of $25,000 in the aggregate;
 
    make any change in its accounting principles or methods; or
 
    enter into any contract to do any of the matters described in the preceding clauses.
Acquisition Proposals
     MedSolutions has agreed that, except as specifically permitted in the merger agreement, it will not, and it will not authorize or permit its subsidiaries or its representatives to:
    solicit, initiate or knowingly encourage the submission of any acquisition proposal (as defined below);
 
    participate in any discussions or negotiations regarding, or furnish to any person any information in respect of, or take any other action to facilitate, any acquisition proposal or any inquiries or the

64


Table of Contents

      making of any proposal that constitutes, or reasonably would be expected to lead to, any acquisition proposal;
 
    approve or recommend to MedSolutions’ shareholders any acquisition proposal.
     An “acquisition proposal” is any inquiry, offer or proposal regarding any of the following matters (other than the transactions contemplated by the merger agreement or the merger):
    an investment in MedSolutions representing (on a post-investment basis) more than 25% of MedSolutions’ capital stock or a purchase from MedSolutions of more than 25% of the shares of its capital stock or any debt securities convertible into or exchangeable for more than 25% of the shares of its capital stock;
 
    a merger, consolidation, share exchange, recapitalization, business combination or other similar transaction involving all of MedSolutions’ equity interests or all shares of the MedSolutions common stock;
 
    the sale, lease, exchange, mortgage, pledge, transfer or other disposition of all or substantially all of MedSolutions’ assets in a single transaction or a series of related transactions;
 
    a tender offer or exchange offer for 25% or more of the outstanding shares of MedSolutions’ capital stock or the filing of a registration statement under the Securities Act of 1933, as amended, in connection with such a tender offer or exchange offer; or
 
    any public announcement of a proposal, plan or intention to do so, or any agreement to engage in, any of the matters described immediately above.
     Except as specifically permitted in the merger agreement, MedSolutions has also agreed to, and will cause its affiliates and their respective officers, directors and representatives to, immediately terminate any activities, discussions or negotiations existing as of the date of the merger agreement with any person (other than Stericycle) conducted with respect to any acquisition proposal.
     However, if MedSolutions receives a superior proposal (as defined below), MedSolutions may terminate the merger agreement if:
    MedSolutions notifies Stericycle of the superior proposal;
 
    MedSolutions gives Stericycle at least five days to propose revisions to the terms of the merger agreement or to make another proposal in response to the competing proposal; and
 
    MedSolutions pays to Stericycle a termination fee of $2,500,000.
     A “superior proposal” is any proposal by a third party to acquire more than 50% of the voting power of MedSolutions’ equity securities or more than 50% of MedSolutions’ assets, pursuant to a tender or exchange offer, merger, consolidation, liquidation or dissolution, recapitalization, sale of assets or otherwise, if MedSolutions’ Board of Directors determines in its good faith judgment (after consultation with MedSolutions’ valuation advisor and after considering the likelihood and timing of the consummation of such third party transaction and any amendments or modifications to the merger agreement that Stericycle has offered or proposed within five days of learning of such proposed transaction) that such transaction is more favorable from a financial point of view to MedSolutions’ shareholders than the merger with Stericycle.

65


Table of Contents

Additional Agreements
     In addition to those covenants described above, the merger agreement contains additional agreements between Stericycle and MedSolutions relating to, among other things:
    convening and holding the MedSolutions special meeting;
 
    preparing, filing and distributing this proxy statement/prospectus and filing the registration statement of which this proxy statement/prospectus is a part;
 
    providing access to information;
 
    using their reasonable best efforts to take all actions and to do all things necessary in order to consummate the merger, including the satisfaction of all closing conditions to the merger in such party’s control;
 
    providing notices, making filings and obtaining permits or consents required in connection with the merger;
 
    providing notice of (i) any representation or warranty in the merger agreement becoming untrue or inaccurate, (ii) the occurrence of any event or development that would cause any representation or warranty to be untrue or inaccurate at the time of the closing of the merger or (iii) the failure to materially comply with or satisfy any covenant, condition or agreement in the merger agreement;
 
    making public announcements;
 
    payment of fees and expenses in connection with the merger;
 
    the termination of all of MedSolutions’ existing employment agreements and accrual of all severance payments and other termination liabilities to its employees at or prior to closing;
 
    payment of certain MedSolutions liabilities within 30 days of closing;
 
    release of certain officers and directors of MedSolutions from their personal guarantees of MedSolutions debt at the effective time of the merger; and
 
    appointment, duties and replacement of MedSolutions’ shareholder representative after the closing.
Conditions Precedent
Conditions to Obligations of Stericycle and Merger Sub
     Unless waived in whole or in part by Stericycle and Merger Sub, the obligations of Stericycle and Merger Sub to effect the merger are subject to the following conditions:
    accuracy as of the closing of the merger of the representations and warranties made by MedSolutions to the extent specified in the merger agreement;
 
    MedSolutions’ performance in all material respects of its covenants and agreements under the merger agreement;
 
    holders of shares of MedSolutions common stock representing no more than 7.5% of the outstanding shares of MedSolutions common stock have exercised (and not withdrawn or otherwise forfeited) the rights of a dissenting owner under Section 5.11 of the TBCA with respect to their shares of MedSolutions common stock;
 
    the approval of the merger by MedSolutions’ shareholders has been obtained;

66


Table of Contents

    Stericycle has entered into consulting agreements and noncompetition agreements with certain officer, directors, employees and shareholders of MedSolutions;
 
    no temporary restraining order, preliminary or permanent injunction or other order issued by a court or governmental authority has been issued and is in effect making the merger illegal or otherwise prohibiting consummation of the merger; and
 
    the registration under the Securities Act of 1933, as amended, of the promissory notes to be issued by Stericycle to holders of MedSolutions common stock in connection with the merger has been declared effective by the SEC.
Conditions to Obligations of MedSolutions
     Unless waived in whole or in part by MedSolutions, the obligations of MedSolutions to effect the merger are subject to the following conditions:
    accuracy as of the closing of the merger of the representations and warranties made by Stericycle and Merger Sub to the extent specified in the merger agreement;
 
    Stericycle’s and Merger Sub’s performance in all material respects of their respective covenants and agreements under the merger agreement;
 
    the approval of the merger by MedSolutions’ shareholders has been obtained; and
 
    no temporary restraining order, preliminary or permanent injunction or other order issued by a court or governmental authority has been issued and is in effect making the merger illegal or otherwise prohibiting consummation of the merger.
Termination
     Before the effective time of the merger, the merger agreement may be terminated:
    by mutual written consent of Stericycle, Merger Sub and MedSolutions;
 
    by either Stericycle or MedSolutions, if:
    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained;
 
    the parties fail to consummate the merger on or before November 30, 2007, unless the failure is the result of a breach of the merger agreement by the party seeking the termination; or
 
    any governmental authority has issued a final and nonappealable order, decree or ruling or has taken any other final and nonappealable action that restrains, enjoins or otherwise prohibits the merger, unless the party seeking the termination has not used its reasonable best efforts to oppose such order or decision or to have such order or decision vacated or made inapplicable to the merger;
    by Stericycle, if:
    MedSolutions materially breaches any of its representations, warranties, covenants or agreements set forth in the merger agreement, and MedSolutions has not cured such breach within 15 business days of receiving written notice from Stericycle of such breach;

67


Table of Contents

    one or more of Stericycle’s conditions precedent to closing the merger are not satisfied or capable of being satisfied on or before November 30, 2007 as a result of MedSolutions’ failure to comply with its obligations under the merger agreement;
 
    MedSolutions’ Board of Directors withdraws or materially and adversely to Stericycle modifies its approval of the merger agreement and the merger, other than as a result of a material breach by Stericycle or Merger Sub of a representation, warranty or covenant under the merger agreement which remains uncured for a period of two business days after receipt of notice from MedSolutions of such breach, or as a result of the failure of any of MedSolutions’ conditions precedent to closing the merger not being met; or
 
    MedSolutions enters into a definitive agreement (other than the merger agreement) to implement:
    an investment in MedSolutions representing (on a post-investment basis) more than 25% of MedSolutions’ capital stock or a purchase from MedSolutions of more than 25% of the shares of its capital stock or any debt securities convertible into or exchangeable for more than 25% of the shares of its capital stock;
 
    a merger, consolidation, share exchange, recapitalization, business combination or other similar transaction involving all of MedSolutions’ equity interests or all shares of the MedSolutions common stock;
 
    the sale, lease, exchange, mortgage, pledge, transfer or other disposition of all or substantially all of MedSolutions’ assets in a single transaction or a series of related transactions;
 
    a tender offer or exchange offer for 25% or more of the outstanding shares of MedSolutions’ capital stock or the filing of a registration statement under the Securities Act of 1933, as amended, in connection with such a tender offer or exchange offer; or
 
    any public announcement of a proposal, plan or intention to do so, or any agreement to engage in, any of the matters described immediately above;
    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained by reason of the violation of the voting agreement by one or more MedSolutions shareholders who are party to the voting agreement.
    by MedSolutions, if:
    either Stericycle or Merger Sub materially breaches any of its representations, warranties, covenants or agreements set forth in the merger agreement, and Stericycle or Merger Sub, as the case may be, has not cured such breach within 15 business days of receiving written notice from MedSolutions of such breach;
 
    one or more of MedSolutions’ conditions precedent to closing the merger are not satisfied or capable of being satisfied on or before November 30, 2007 as a result of either Stericycle’s or Merger Sub’s failure to comply with its obligations under the merger agreement; or
 
    MedSolutions enters into a definitive agreement providing for the implementation of a superior proposal, which is defined as the acquisition by a third party of more than 50% of the voting power of MedSolutions’ equity securities or more than 50% of MedSolutions’ assets, pursuant to a tender or exchange offer, merger, consolidation, liquidation or dissolution, recapitalization, sale of assets or otherwise, if MedSolutions’ Board of Directors has determined in its good faith judgment, after consultation with MedSolutions’ valuation advisor and after considering the likelihood and timing of the consummation of such third

68


Table of Contents

      party transaction and any amendments or modifications to the merger agreement that Stericycle has offered or proposed within five days of learning of such proposed transaction, that such transaction is more favorable from a financial point of view to MedSolutions’ shareholders than the merger with Stericycle.
     If the merger agreement is validly terminated, the merger agreement will become void without any liability on the part of any party unless that party is in breach. However, certain provisions of the merger agreement, including, among others, those provisions relating to expenses and termination fees, will continue in effect notwithstanding termination of the merger agreement.
Fees and Expenses
     MedSolutions must pay to Stericycle a termination fee of $2,500,000 in the following circumstances:
    if MedSolutions terminates the merger agreement because MedSolutions enters into a definitive agreement providing for the implementation of a superior proposal, which is defined as the acquisition by a third party of more than 50% of the voting power of MedSolutions’ equity securities or more than 50% of MedSolutions’ assets, pursuant to a tender or exchange offer, merger, consolidation, liquidation or dissolution, recapitalization, sale of assets or otherwise, if MedSolutions’ Board of Directors has determined in its good faith judgment, after consultation with MedSolutions’ valuation advisor and after considering the likelihood and timing of the consummation of such third party transaction and any amendments or modifications to the merger agreement that Stericycle has offered or proposed within five days of learning of such proposed transaction, that such transaction is more favorable from a financial point of view to MedSolutions’ shareholders than the merger with Stericycle; or
 
    if Stericycle terminates the merger agreement because:
    MedSolutions’ Board of Directors withdraws or materially and adversely to Stericycle modifies its approval of the merger agreement and the merger, other than as a result of a material breach by Stericycle or Merger Sub of a representation, warranty or covenant under the merger agreement which remains uncured for a period of two business days after receipt of notice from MedSolutions of such breach, or as a result of the failure of any of MedSolutions’ conditions precedent to closing the merger not being met;
 
    MedSolutions enters into a definitive agreement (other than the merger agreement) to implement:
    an investment in MedSolutions representing (on a post-investment basis) more than 25% of MedSolutions’ capital stock or a purchase from MedSolutions of more than 25% of the shares of its capital stock or any debt securities convertible into or exchangeable for more than 25% of the shares of its capital stock;
 
    a merger, consolidation, share exchange, recapitalization, business combination or other similar transaction involving all of MedSolutions’ equity interests or all shares of the MedSolutions common stock;
 
    the sale, lease, exchange, mortgage, pledge, transfer or other disposition of all or substantially all of MedSolutions’ assets in a single transaction or a series of related transactions;
 
    a tender offer or exchange offer for 25% or more of the outstanding shares of MedSolutions’ capital stock or the filing of a registration statement under the Securities Act of 1933, as amended, in connection with such a tender offer or exchange offer; or

69


Table of Contents

    any public announcement of a proposal, plan or intention to do so, or any agreement to engage in, any of the matters described immediately above; or
    adoption of the merger agreement and approval of the merger by the MedSolutions shareholders is not obtained by reason of the violation of the voting agreement by one or more of MedSolutions’ shareholders who are party to the voting agreement.
     In general, each of Stericycle, Merger Sub and MedSolutions will bear its own expenses in connection with the merger agreement and the related transactions. If the merger is consummated, the surviving corporation to the merger will pay MedSolutions’ transaction expenses up to $100,000. If the merger is not consummated, all expenses incurred in connection with the merger agreement and the related transactions will be paid by the party incurring them. If the merger is consummated, Stericycle will pay for the expenses of the payment agent selected to distribute the merger consideration and the indenture trustee for the notes up to $80,000.
Amendment
     Stericycle, Merger Sub and MedSolutions, by action taken or authorized by their respective boards of directors, may amend the merger agreement in writing at any time before the effective time of the merger. However, after the approval of the merger agreement by the MedSolutions shareholders, no amendment may be made that by law would require further approval by the MedSolutions shareholders without such further approval.
Extension; Waiver
     Stericycle, Merger Sub and MedSolutions may at any time before the effective time of the merger and to the extent legally allowed:
    extend the time for the performance of any of the obligations or the other acts of the other parties;
 
    waive any inaccuracies in the representations and warranties contained in the merger agreement or in any document delivered pursuant to the merger agreement; or
 
    waive compliance with any of the agreements or conditions contained in the merger agreement.

70


Table of Contents

DESCRIPTION OF PROMISSORY NOTES
     The following description summarizes the material terms of the promissory notes. The promissory notes consist of 4.5% Promissory Notes Due 2014 (the “4.5% notes”) and 3.5% Promissory Notes (Letter of Credit Supported) Due 2014 (the “3.5% notes”). This summary is subject to, and qualified in its entirety by reference to, the indenture relating to the 4.5% notes (the “4.5% indenture”) and the indenture relating to the 3.5% notes (the “3.5% indenture”) (together, the “indentures”), which Stericycle has entered into with LaSalle Bank National Association, Chicago, Illinois as indenture trustee.
     We urge you read the indentures because the terms and provisions of the promissory notes include the terms and provisions set out in the indentures and the terms and provisions made part of the indentures by reference to the Trust Indenture Act of 1939. The 4.5% indenture is included in this proxy statement/prospectus as Annex E, and the 3.5% indenture is included as Annex F. The form of the 4.5% notes is Exhibit A to the 4.5% indenture; the form of the 3.5% notes is Exhibit A to the 3.5% indenture.
General
     Stericycle will issue promissory notes up to the aggregate principal amount of $40,742,903 in connection with the merger. The promissory notes will be in registered form. The promissory notes will be transferable or exchangeable only upon registration of the transfer or exchange with LaSalle Bank National Association as the registrar as under the indentures.
     Stericycle will issue promissory notes to each shareholder of MedSolutions and each holder of MedSolutions stock options upon the shareholder’s or option holder’s compliance with the requirements of the letter of transmittal in connection with payment of the merger consideration. See “The Merger Agreement—Merger Consideration,” “—Treatment of MedSolutions Options” and “—Payment Procedures” on pages 54, 55 and 56, respectively, of this proxy statement/prospectus.
     The promissory notes will be issued without coupons and will mature on the seventh anniversary of the closing of the merger, which will fall in 2014. The promissory notes will be general obligations of Stericycle. They will not be secured by any of Stericycle’s assets.
     Payment of the 3.5% notes will be supported by a letter of credit issued by Bank of America, N.A., any other lender party to the Stericycle’s current credit agreement, or any other bank or financial institution approved by the shareholder representative, and paid for by Stericycle. Payment of the 4.5% notes will not be supported by a letter of credit.
     When returning their completed letters of transmittal, shareholders of MedSolutions and holders of MedSolutions stock options may elect to receive either 3.5% notes or 4.5% notes or a combination of 3.5% notes and 4.5% notes. Once the promissory notes have been issued, however, holders of promissory notes (“noteholders”) may not exchange 4.5% notes for 3.5% notes or 3.5% notes for 4.5% notes.
     The promissory notes are not subject to any sinking fund provisions.
Interest
     Interest on the unpaid principal balance of the 3.5 % promissory notes will accrue at the rate of 3.5% per annum, and interest on the unpaid principal balance of the 4.5% promissory notes will accrue at the rate of 4.5% per annum.

71


Table of Contents

     Interest will be payable annually in arrears on each anniversary of the closing date of the merger falling in 2008, 2009, 2010, 2011, 2012, 2013 and 2014.
Principal
     The unpaid principal balance of the 3.5% and 4.5% notes will be due and payable on the seventh anniversary of the closing date of the merger, which will fall in 2014.
Method of Payment
     Stericycle will pay interest on the promissory notes to the persons who are registered holders of promissory notes as of the close of business on the record date for the interest payment on or immediately before the interest payment date.
     Holders of promissory notes will be required to surrender their notes to the payment agent to collect principal payments. Stericycle has appointed the indenture trustee as the payment agent.
Letter of Credit
     Payment of the 3.5% notes will be supported by a letter of credit issued to the indenture trustee. The issuer of the initial letter of credit will be Comerica Bank.
     The initial letter of credit will be for a one-year term, subject to being renewed automatically for additional one-year terms unless the issuer gives the indenture trustee, Stericycle and the shareholder representative 30 days’ prior notice of the issuer’s intent not to renew the letter of credit upon the expiry of its current one-year term.
     If the issuer of the current letter of credit gives the indenture trustee, Stericycle and the shareholder representative at least 30 days’ prior notice of the issuer’s intent not to renew the letter of credit upon the expiry of its current one-year term, Stericycle is required by the 3.5% indenture to deliver a new letter of credit to the indenture trustee no later than 15 days prior to the expiry of the current letter of credit.
     Stericycle may at any time substitute a new letter of credit for the current letter of credit. Any new letter of credit is required to be issued by Bank of America, N.A., any other lender party to Stericycle’s credit agreement for its senior unsecured credit facility, or any other bank or financial institution approved by the shareholder representative (whose approval may not be unreasonably withheld), and conform in substance to the current letter of credit that it replaces.
Reduction in Payments
     Payments under the promissory notes are subject to reduction by reason of an indemnification claim payment reduction. This reduction is in the nature of a dollar-for-dollar offset. See “The Merger Agreement—Representations and Warranties and Indemnification” on page 57 of this proxy statement/prospectus.
     In the event of an indemnification claim payment reduction, the payments otherwise next becoming due under all outstanding promissory notes will be reduced on a pro rata basis.

72


Table of Contents

Reduction in Principal
     The principal amount of the promissory notes is subject to reduction, retroactive to the date of issuance of the promissory notes, by reason of a merger consideration principal reduction. The principal amount of the promissory notes is also subject to reduction, effective as of the date of payment, by reason of a litigation payment principal reduction or an expense payment principal reduction. See “The Merger Agreement— Merger Consideration,” “The Merger Agreement — Payment Procedures,” “The Merger Agreement — Adjustments to Merger Consideration—Application of Closing Balance Sheet and Revenue Adjustments” and “ — Litigation Adjustment” on pages 54, 56, 60 and 61 of this proxy statement/prospectus.
     In the event of a merger consideration principal reduction, a litigation payment principal reduction or an expense payment principal reduction, the principal amount of all outstanding promissory notes will be reduced on a pro rata basis.
Prepayment
     Stericycle, at its option, may prepay all or any portion of the principal amount of the promissory notes without penalty at any time prior to the maturity date if it concurrently pays all accrued interest on the principal amount being prepaid. Any prepayment of principal will be made in respect of all outstanding promissory notes on a pro rata basis determined by the promissory notes’ respective principal amounts.
Merger and Sale of Assets
     Each indenture provides that Stericycle may not consolidate or merge with or into or transfer all or substantially all of its assets to a third party unless (i) Stericycle is the resulting or surviving entity, or (ii) if Stericycle is not the resulting or surviving entity, the resulting or surviving entity is a U.S. corporation and assumes all of Stericycle’s obligations under the promissory notes and the indenture and, in either case (i) or (ii), (iii) immediately before and immediately after the transaction there is no default under the indenture.
No Financial Covenants
     The indentures and the promissory notes do not contain any financial covenants by Stericycle. There are no provisions requiring the maintenance of any asset ratio or restricting the incurrence of additional debt or restricting the declaration of dividends.
Events of Default
     Under each indenture, an event of default occurs in respect of the promissory notes issued pursuant to the indenture if:
    Stericycle fails to pay interest on any promissory note when it becomes due and payable and its failure continues for a period of 10 days;
 
    Stericycle fails to pay the principal of any promissory note when it becomes due and payable at maturity;
 
    Stericycle fails to comply with any of its other agreements in the promissory notes or the indenture and its failure continues for a period of 30 days after the indenture trustee or the shareholder representative gives Stericycle notice of the default;

73


Table of Contents

    an event of bankruptcy, insolvency or liquidation specified in the indenture has occurred;
 
    in the case of the 3.5% indenture, there is an event of default under the 4.5% indenture, and in the case of the 4.5% indenture, there is an event of default under the 3.5% indenture; or
 
    in the case of the 3.5% indenture, Stericycle fails to deliver a new letter of credit when required by the terms of the indenture.
Acceleration of Notes
     Under each indenture, if an event of default occurs, the indenture trustee by notice to Stericycle, or the shareholder representative by notice to Stericycle and the indenture trustee, may declare the principal of and accrued interest on all outstanding promissory notes issued pursuant to the indenture to be due and payable.
     The indenture trustee is required to declare the principal of and accrued interest on all outstanding promissory notes issued pursuant to one indenture to be due and payable if the principal of and accrued interest on all outstanding promissory notes issued pursuant to the other indenture have been declared to be due and payable.
     The shareholder representative may direct (i) the time, method and place of conducting any proceeding for any remedy available to the indenture trustee or (ii) the exercise of any trust or other power conferred on the indenture trustee, including drawing on the letter of credit supporting the 3.5% Notes.
     The shareholder representative by notice to Stericycle and the indenture trustee may rescind an acceleration and its consequences if the rescission would not conflict with any judgment or decree and if all existing events of default have been cured or waived except the nonpayment of principal or interest that became due solely because of the acceleration.
Modification and Waiver
     Stericycle and the indenture trustee may amend each indenture or the promissory notes issued pursuant to the indenture without the consent of any noteholder in order to:
    cure any ambiguity, defect or inconsistency;
 
    comply with provisions of the indenture relating to the circumstances in which Stericycle is permitted to merge with a third party; or
 
    make any change that does not adversely affect the rights of any noteholder.
     Stericycle and the indenture trustee may amend each indenture or the promissory notes issued pursuant to the indenture with the written consent of the shareholder representative. Without the consent of each affected noteholder, however, no amendment may:
    reduce the interest on or change the time for payment of interest on any promissory note, except in limited circumstances as expressly set forth in the merger agreement (see “The Merger Agreement—Adjustments to Merger Consideration” beginning on page 59 of this proxy statement/prospectus);

74


Table of Contents

    reduce the principal of or change the fixed maturity of any promissory note, except in limited circumstances as expressly set forth in the merger agreement (see “The Merger Agreement—Adjustments to Merger Consideration” beginning on page 59 of this proxy statement/prospectus);
 
    make any promissory note payable in money other than that stated in the promissory note; or
 
    make any change in the provisions of the indenture relating to waiver of past defaults, limitations on noteholders’ right to sue, or actions requiring the consent of the noteholders.
Reporting Obligations
     Under each indenture, Stericycle is required to file with the indenture trustee copies of all annual, quarterly and current reports that it required to file with the SEC. Stericycle is also required to file with the indenture trustee an annual compliance certificate signed by its principal executive office, principal financial officer or principal accounting officer certifying to Stericycle’s compliance with the conditions and covenants of the indenture to the signing officer’s knowledge.
Governing Law
     The indentures and the promissory notes will be governed by the laws of the State of Illinois.
Information Concerning the Trustee
     LaSalle Bank National Association is the indenture trustee under the indentures. Its address is 135 South LaSalle Street, Suite 1560, Chicago, Illinois 60603. Stericycle has also appointed the indenture trustee as the initial registrar and payment agent under the indentures.
     Stericycle may maintain banking and other commercial relationships with the indenture trustee and its affiliates in the ordinary course of business. The indenture trustee in its individual or any other capacity may become the owner or pledgee of promissory notes and may otherwise deal with Stericycle or its affiliates with the same rights that it would have had if it were not indenture trustee.
     The indenture trustee may refuse to follow any direction by the shareholder representative that conflicts with law or the indentures, is unduly prejudicial to the rights of noteholders, or would involve the trustee in personal liability or expense for which the trustee has not received a satisfactory indemnity.
     The indenture trustee may refuse to perform any duty or exercise any right or power under the indentures that would require it to expend its own funds or risk any liability if it reasonably believes that repayment of such funds or adequate indemnity against such risk is not reasonably assured to it.

75


Table of Contents

INFORMATION ABOUT STERICYCLE
General
     Stericycle is in the business of managing regulated waste and providing an array of related services. Stericycle operates in the United States, Canada, Mexico, the United Kingdom, Ireland and Argentina.
     For large-quantity generators of regulated waste such as hospitals and for pharmaceutical companies and distributors, Stericycle offers:
    its institutional regulated waste management services
 
    its Bio Systems® management services to reduce the risk of needle sticks
 
    a variety of products and services for infection control
 
    its regulated returns management services for expired or recalled healthcare products
     For small-quantity generators of regulated waste such as doctors’ offices and for retail pharmacies, Stericycle offers:
    its regulated waste management services
 
    its Steri-Safe® Occupational Safety and Health Act and Health Insurance Portability and Accountability Act (HIPAA) compliance programs
 
    a variety of products and services for infection control
 
    its regulated returns management services for expired or recalled healthcare products
     Stericycle operates integrated national regulated waste management networks in the United States, Canada, Mexico, Argentina, the United Kingdom and Ireland. Stericycle’s national networks include a total of 76 processing or combined processing and collection sites and 104 additional transfer, collection or combined transfer and collection sites.
     Stericycle’s regulated waste processing technologies include autoclaving, Stericycle’s proprietary electro-thermal-deactivation system (ETD), chemical treatment and incineration.
     Stericycle serves approximately 351,700 customers worldwide, of which approximately 8,600 are large-quantity generators, such as hospitals, blood banks and pharmaceutical manufacturers, and approximately 343,100 are small-quantity generators, such as outpatient clinics, medical and dental offices, long-term and sub-acute care facilities and retail pharmacies.
     Stericycle benefits from significant customer diversification. No one customer accounts for more than 2% of Stericycle’s total revenues, and its top 10 customers account for approximately 9% of total revenues.
     Additional information about Stericycle is provided in its 2006 Form 10-K, which has been delivered with this proxy statement/prospectus, and in the other documents that Stericycle has filed with the Securities and Exchange Commission and incorporated by reference in this proxy statement/prospectus. See “Where You Can Find More Information” on page 215.

76


Table of Contents

Directors and Executive Officers
     For information about Stericycle’s directors and executive officers, please see Stericycle’s 2006 Form 10-K, which has been delivered with and incorporated by reference in this proxy statement/prospectus, and Stericycle’s proxy statement for its 2007 Annual Meeting of Stockholders, which has been incorporated by reference in this proxy statement/prospectus.
Beneficial Ownership of Stericycle Stock
     For information about beneficial ownership of Stericycle’s common stock, please see Stericycle’s 2006 Form 10-K, which has been delivered with and incorporated by reference in this proxy statement/prospectus, and Stericycle’s proxy statement for its 2007 Annual Meeting of Stockholders, which has been incorporated by reference in this proxy statement/prospectus.

77


Table of Contents

INFORMATION ABOUT MEDSOLUTIONS
Description of MedSolutions’ Business
Company Overview
     MedSolutions, a Texas corporation that was organized on November 11, 1993, is a diversified holding company that provides complete and effective waste management outsource solutions marketed and serviced through four wholly owned subsidiaries and one substantially owned subsidiary. Through EnviroClean Management Services, Inc. (“EMSI”), from which MedSolutions currently derives virtually all of its revenue, MedSolutions is primarily engaged in regulated medical waste (“RMW”) management services, which include collecting, transporting, treating and disposing of regulated medical waste from a variety of healthcare customers. Through SharpsSolutions, Inc. (“SharpsSolutions”), MedSolutions offers a reusable sharps container service program to healthcare facilities that it expects will virtually eliminate the current method of utilizing disposable sharps containers. Through ShredSolutions, Inc., MedSolutions markets a fully integrated, comprehensive service for the collection, transportation and destruction of protected healthcare Information (“PHI”) and other confidential documents, primarily those generated by healthcare providers and regulated under the Health Insurance Portability and Accountability Act (“HIPAA”). Through Positive Impact Waste Servicing, Inc. doing business as EnviroClean On-Site, MedSolutions provides a patented mobile treatment process that uses Cold-Ster®, a proprietary dry chemical product approved by the U.S. Environmental Protection Agency (“EPA”) for the treatment of RMW. Through the acquisition of SteriLogic Waste Systems, Inc., located in Syracuse, New York (“SteriLogic”), MedSolutions operates a regulated medical waste management company that provides collection, transportation and disposal of regulated medical waste services in addition to providing a reusable sharps container program to its customers who are primarily located in the States of New York and Pennsylvania. SteriLogic also designs, manufactures and markets reusable sharps containers to medical waste service providers who provide a reusable sharps container program to their medical waste customers.
     MedSolutions is a fully integrated regulated medical waste management company providing medical waste and PHI collection, transportation, treatment and disposal, sharps container management, and related consulting, training and education services and products. MedSolutions’ three principal groups of customers include (i) outpatient clinics, medical and dental offices, biomedical companies, municipal entities, long-term and sub-acute care facilities and other smaller-quantity generators (“SQG”) of regulated medical waste, (ii) blood banks, surgery centers, dialysis centers and other medium quantity generators (“MQG”) of regulated medical waste and (iii) hospitals, diagnostic facilities and other larger-quantity generators (“LQG”) of regulated medical waste. MedSolutions believes that the services it offers are compelling to its customers because they allow its customers to avoid the significant capital and operating costs that they would have to incur if they were to manage their regulated medical waste, sharps container management, on-site treatment, or PHI destruction internally. Moreover, by outsourcing waste management, sharps container management, on-site treatment, PHI destruction, regulatory compliance and other services to MedSolutions, its customers reduce or eliminate their risk of the large fines associated with regulatory non-compliance.
Business Background
     MedSolutions was originally incorporated as Advanced EnviroTech Systems, Inc. for the purpose of developing, designing and manufacturing a patented solid waste treatment technology, the EnviroClean® Thermal Oxidation System, which may sometimes be referred to in this proxy statement/prospectus as the “EnviroClean® System”, for the destruction of regulated medical and other specialized waste streams generated by the medical, commercial and industrial business communities in an environmentally sound

78


Table of Contents

manner. MedSolutions subsequently changed its name to EnviroClean International, Inc. MedSolutions has two issued patents (No. 5,680,820 and No. 5,730,072) and a trademark regarding the EnviroClean® System. Although MedSolutions was established for the purpose of developing, manufacturing and marketing the EnviroClean® System, its success in that regard has been marginal, and MedSolutions has not produced significant revenue or any profit from such activities. Lack of funds for the development, modification and marketing of the EnviroClean® System, coupled with the general lack of acceptance and demand, and the cost of production and operation of the product, contributed to MedSolutions’ disappointing results in prior periods. There are no plans to reactivate the development of the EnviroClean System. In 1999, MedSolutions altered its focus from the development of the EnviroClean® System to the development of its regulated medical waste management service business, changed its corporate name and modified its business model. In addition, MedSolutions subsequently began to focus on the creation and development of subsidiaries to provide its large base of healthcare provider customers with other healthcare related waste management services and regulatory compliance programs. From the point MedSolutions elected to implement these changes in its business strategy, MedSolutions’ business has seen a dramatic turnaround and a much more receptive market.
Industry Overview
     The regulated medical waste industry arose with the Medical Waste Tracking Act of 1988, or MWTA, which Congress enacted in response to media attention after medical waste washed ashore on ocean beaches, particularly in New York and New Jersey. Since the 1980s, government regulation has increasingly required the proper handling and disposal of the medical waste generated by the healthcare industry. Regulated medical waste is generally described as any medical waste that can cause an infectious disease, including single-use disposable items, such as needles, syringes, gloves and other medical supplies; cultures and stocks of infectious agents; and blood and blood products.
     According to publicly available information, the size of the regulated medical waste market in the United States is approximately $3.0 billion and is in excess of $10.0 billion when ancillary services such as PHI destruction, reusable sharps container programs, training, education, product sales and regulatory compliance programs are taken into consideration. Industry growth is driven by a number of factors. These factors include:
     Pressure To Reduce Hospital Costs. The healthcare industry is under pressure to reduce costs and improve efficiency. To accomplish this reduction, outside contractors are being hired to perform some services, including medical waste management, PHI destruction and reusable sharps container programs. MedSolutions believes that its medical waste management services help healthcare providers reduce costs by reducing their medical waste tracking, handling and compliance costs, reducing their potential liability related to employee exposure to blood borne pathogens and other infectious materials, and reducing the amount of money invested in on-site treatment of medical waste and/or PHI destruction.
     Shift to Off-Site Treatment. MedSolutions believes that managed care and other healthcare cost-containment pressures are causing patient care to shift from institutional, higher-cost, acute-care settings to less expensive, smaller, off-site treatment alternatives. Many common diseases and conditions are now being treated in smaller non-institutional settings. MedSolutions believes that these non-institutional, alternate-site, healthcare expenditures will continue to grow as cost-cutting pressures increase. Typically these type of settings generate only small amounts of medical waste; thus, the potential risks of non-compliance with applicable state and federal medical waste regulations is disproportionate to the cost of services MedSolutions can provide.
     Aging of U.S. Population. The relative size of the baby boom generation should continue to result in an increase in the average age of the population, while falling mortality rates ensure that the average

79


Table of Contents

person should live longer. As people age, they typically require more medical attention and a wider variety of tests and procedures. In addition, as technology improves more tests and procedures become available. All of these factors lead to increased generation of medical waste.
     Environmental and Safety Regulation. MedSolutions’ industry is subject to extensive regulation beyond the MWTA. For example, the Clean Air Act Amendments of 1990 (the “Clean Air Act”) regulations adopted in 1997 limit the discharge into the atmosphere of pollutants released by medical waste incineration. These regulations have increased the costs of operating medical waste incinerators and have resulted in the closures of several on-site treatment facilities, thereby increasing the demand for off-site treatment services. In addition, the Occupational Safety and Health Administration (“OSHA”) has issued regulations concerning employee exposure to blood borne pathogens and other potentially infectious materials that require, among other things, special procedures for the handling and disposal of medical waste and annual training of all personnel who may be exposed to blood and other bodily fluids. These regulations underlie the expansion of MedSolutions’ service offerings to include OSHA compliance services for healthcare providers.

80


Table of Contents

Services and Operations
     MedSolutions’ services and operations are comprised of the collection, transportation, treatment, and disposal of regulated medical waste, reusable sharps containers and PHI, together with regulatory compliance training and education programs and consulting services. To service its customers, MedSolutions has one collection/treatment facility and two transfer sites in the State of Texas, one collection/treatment/transfer facility in the State of Oklahoma and one transfer site and one collection/treatment facility in the state of Kansas. MedSolutions offers programs to assist its customers in the proper handling, separating, packaging and disposing of medical waste. MedSolutions also advises its healthcare customers in the proper methods of recording and documenting their medical waste management to comply with federal, state and local regulations. In addition, MedSolutions offers consulting services to its healthcare customers for OSHA and HIPAA compliance and to assist them in reducing the amount of medical waste they generate. MedSolutions has approximately 10,000 medical waste disposal agreements with customers for the collection of their regulated medical waste, sharps management, and/or PHI. MedSolutions’ customers include the Texas Health Resources Hospital System, the Greater Ozarka Health Care System, St. Joseph Hospitals, Carter Blood Care, Tenet Healthcare System, Quest Diagnostics, Inc., East Texas Medical Center, St. Luke’s Episcopal Health System, The Methodist Health System, Hospital Corporation of America and many others.
     Collection and Transportation. MedSolutions considers efficiency of collection and transportation to be a critical element of its operations because it represents approximately one-half of MedSolutions’ cost of revenues. MedSolutions has sophisticated routing software to optimize its routes. MedSolutions tries to maximize the number of stops on each route. MedSolutions use a global positioning system (“GPS”) for certain of its collection vehicles to improve efficiency. MedSolutions attempts to correlate the size of its collection vehicles to the amount of medical waste to be collected at a particular stop or on a particular route. MedSolutions collects reusable containers or corrugated boxes of medical waste from its customers at intervals depending upon customer requirements, terms of service and volume of medical waste produced. The containers or boxes are inspected at each customer’s site prior to pickup. The waste is then transported directly to one of MedSolutions’ treatment facilities or to one of its transfer stations where it is combined with other medical waste and transported to a treatment facility. In some select circumstances MedSolutions transports medical waste to other permitted medical waste treatment facilities.
     As part of its collection operations, MedSolutions supplies specially designed containers for use by most of its customers. MedSolutions has reusable plastic containers that are leak and puncture resistant. The plastic containers enable MedSolutions’ customers to reduce costs by reducing the number of times that medical waste is handled, eliminating the cost (and weight) of corrugated boxes and potentially reducing liability resulting from human contact with medical waste. The plastic containers are designed to maximize the loads that will fit within the cargo compartments of MedSolutions’ standard trucks and trailers. If a customer generates a large volume of waste, MedSolutions will place a large temporary storage container or trailer on the customer’s premises. In order to maximize regulatory compliance and minimize potential liability, MedSolutions will not accept medical waste unless it is properly packaged by customers in containers that MedSolutions has either supplied or approved.
     Treatment and Disposal. Upon arrival at a treatment facility, containers or boxes of medical waste are typically scanned to verify that they do not contain any unacceptable substances such as radioactive materials. Any container or box that is discovered to contain unacceptable waste is returned to the customer. After inspection, the waste is treated using one of MedSolutions’ treatment technologies. Upon completion of the particular process, the resulting waste or incinerator ash is transported for disposal in a landfill operated by parties unaffiliated with MedSolutions. After the plastic containers have been emptied, they are washed, sanitized and returned to customers for re-use. MedSolutions also receives medical waste to process from third party transporters which provides another source of revenue.

81


Table of Contents

     Treatment Technologies. MedSolutions currently uses autoclaving, incineration and chemical mobile technologies for treating regulated medical waste.
     Autoclaving. Autoclaving treats medical waste with steam at high temperature and pressure to kill pathogens. Autoclaving alone does not change the appearance of waste, and recognizable medical waste may not be accepted by some landfill operators, but autoclaving may be combined with a shredding or grinding process to render the medical waste unrecognizable.
     Incineration. Incineration burns medical waste at elevated temperatures and reduces it to ash. Incineration reduces the volume of waste, and it is the recommended treatment and disposal option for some types of medical waste such as anatomical waste or residues from chemotherapy procedures. However, air emissions from incinerators can contain certain byproducts, which are subject to federal, state and, in some cases, local regulation. In addition, the ash byproduct of incineration may be regulated in some instances.
     Chemical Mobile Treatment. MedSolutions employs a chemical mobile treatment process which treats medical waste that uses Cold-Ster®, a proprietary dry chemical product approved by the EPA for the treatment of regulated medical waste. The features of this treatment come from an exclusive long-term, proven mobile technology that treats RMW, reduces its volume by 70% and transforms the waste into a shredded material that is unrecognizable, HIPPA-compliant and ready for the general waste stream.
     MedSolutions’ currently treats regulated medical waste using three treatment methods, which are approximately divided in the following percentages:
         
Autoclaving
    75 %
Incineration
    15 %
Chemical Mobile
    10 %
     MedSolutions varies its treatment of medical waste among available treatment technologies based on the type of waste and capacity and pricing considerations in each service area, in order to minimize operating costs and capital investments.
     Disposal Operations. MedSolutions operates multiple permitted treatment/transfer facilities. MedSolutions’ treatment/transfer facility located in Garland, Texas (a suburb of Dallas) services North Texas, Oklahoma, Arkansas and Louisiana (the “Garland Facility”). Its treatment facility in Emporia, Kansas currently services the Kansas, Oklahoma, Missouri and Northern Arkansas markets. MedSolutions has a transfer facility located in Houston, Texas which services customers located in South Texas and Southern Louisiana with an emphasis on the Greater Houston, Corpus Christi and San Antonio/Austin service areas. MedSolutions also operates transfer sites in Oklahoma City, Oklahoma; and Wichita, Kansas.
     On June 8, 2006, the operating agreement between MedSolutions and the University of Texas Medical Branch (“UTMB”) expired. The operating agreement allowed MedSolutions to manage the UTMB incineration facility and process their waste for a fee as well as provided a facility for MedSolutions to treat waste generated from EMSI South Texas and Louisiana customers in return for a fee paid to UTMB. Currently, MedSolutions is taking waste generated from South Texas and Louisiana customers to other third party facilities in South Texas and Northern Louisiana and to its Garland facility.

82


Table of Contents

     Chemical Mobile Treatment Technology. Positive Impact Waste Servicing, Inc. doing business as EnviroClean On-Site, Inc., which was acquired by MedSolutions from Positive Impact Waste Solutions, LLC in 2005, employs a patented mobile treatment process that uses Cold-Ster, a proprietary dry chemical product approved by the U.S. EPA for the treatment of RMW. EnviroClean On-Site features an exclusive long-term, proven mobile technology that treats RMW, reduces its volume by 70%, and transforms the waste into a shredded material that is unrecognizable, HIPPA-compliant and ready for the general waste stream. The mobile treatment technology affords MedSolutions the opportunity of reduced permitting constraints and allows for the rapid establishment of a customer base and recurring revenue stream in new markets. This approach is superior to the conventional method of permitting a fixed facility to allow for geographical market expansion that requires significant time and capital expenditures prior to the establishment of a revenue stream. In addition, it allows MedSolutions to compete for those LQG customers that prefer on-site treatment for liability reasons.
     Consulting Services. Before medical waste is picked up by its trucks, MedSolutions’ integrated waste management approach attempts to “build in” efficiencies that will yield advantages for its customers. For example, MedSolutions’ consulting services can assist its customers in reducing the volume of medical waste that they generate or assist them with regulatory compliance training. In addition, MedSolutions provides customers with the documentation necessary for compliance with laws, which, if they complete the documentation properly, will reduce interruptions to their businesses to verify compliance.
     Documentation. MedSolutions provides complete documentation to its customers for all medical waste and PHI that MedSolutions collects, including the name of the generator, date of pick-up and date of delivery to a treatment facility. MedSolutions believes that its documentation system meets all applicable federal, state and local regulations regarding the packaging and labeling of medical waste, including regulations issued by the U.S. Department of Transportation (“DOT”), OSHA and state and local authorities. This documentation is sometimes used by MedSolutions’ customers to prove that they are in compliance with these regulations.
     SharpsSolutions, Inc.—Reusable Sharps Container Program. MedSolutions’ reusable sharps container program is perhaps one of the most significant investments and opportunities that MedSolutions is currently undertaking. Sharps management is defined as the management and treatment of sharp-edged medical waste such as syringes, needles, razors, scissors and scalpels that may have come into contact with blood born pathogens, such as HIV or hepatitis. The most common sharps management is where the hospital employees dispose of sharps in various containers that are then collected by other hospital employees and disposed (container and sharps content together) within the hospitals’ waste that is then treated in-house or outsourced to a medical waste service provider such as MedSolutions. The SharpsSolutions Reusable Sharps Container Program is intended to be a fully outsourced service offering where hospital employees do not handle the sharps once they are disposed of at the point of use. This is paramount for hospitals in that hospital personnel are less subject to needle stick injuries.
     Statistically, there are 600,000 to 800,000 needle stick injuries annually, with a third of them occurring during the disposal process. With each needle stick costing between $5,000 and $10,000, these incidents alone are costing the industry over one billion dollars annually. In addition to the cost/liability savings associated with reduced needle stick incidents, the cost of recycling the containers rather than purchasing them is significant, often saving 15 to 20% for the generator. The combined savings between direct costs plus costs associated with reduced needle sticks can reach up to 30% per year.
     Currently, the reusable sharps container recycling market is rapidly developing. It is very popular on the east coast of the United States where approximately 80% of the market utilizes reusable sharps programs. MedSolutions estimates, based on research conducted by industry analysts and its own conservative estimates, that there is a total market opportunity in the markets it services of approximately

83


Table of Contents

$20 million annually. As of December 31, 2006, MedSolutions provides reusable sharps container programs to 14 hospitals in the markets it services.
     ShredSolutions, Inc. – Document Destruction Program. ShredSolutions benefits from HIPPA, a law that became effective in April 2003 which stipulates that healthcare providers guarantee the security and privacy of health information by requiring that every identifiable patient record for individuals be transferred to an electronic medium or destroyed.
     EnviroSafe Complete Compliance Program. The EnviroSafe program is a competitive program to Stericycle’s extremely lucrative SteriSafe program.
Business Strategy
     MedSolutions’ goals are to strengthen its position as a regional provider of integrated services in the regulated medical waste industry and to continuously improve its financial performance. Components of MedSolutions’ strategy to achieve these goals include:
     Improve Margins. MedSolutions continues to actively work to improve its margins by increasing its base of small quantity generators and focusing on its ancillary service strategies, including reusable sharps container programs, PHI destruction and regulatory compliance programs. These services fulfill the needs of MedSolutions’ large, medium and small quantity generators, and MedSolutions believes that with the rapid organic and acquisition growth of its customer base, the opportunity for sales of ancillary services and regulatory compliance products to its customers will continue to grow and the incremental cost of offering these services will continue to decrease, thereby improving margins.
     Expand Range of Services and Products. MedSolutions believes that it has the opportunity to expand its business by increasing the range of products and services that it offers to its existing customers. For example, MedSolutions now offers on-site treatment, reusable sharps container management, PHI destruction and a broad range of OSHA compliance and consulting services to its customers. Because MedSolutions’ drivers call on numerous medical facilities on a routine basis, it is considering offering single-use disposable medical supplies to its customers.
     Seek Strategic and/or Complementary Acquisitions. MedSolutions actively seeks strategic opportunities to acquire businesses that expand its network of treatment centers and increase its customer base. MedSolutions believes that strategic acquisitions can enable it to gain operating efficiencies through increased capacity utilization and increased route density as well as to expand the geographic service areas in which MedSolutions operates.
     Capitalize on Outsourcing Due to Clean Air Regulations. The Clean Air Act regulations have increased both the capital costs required to bring many existing incinerators into compliance and the operating costs of continued compliance. MedSolutions plans to continue to try and capitalize on the anticipated movement by hospitals to outsource medical waste treatment rather than incur the cost of installing the air pollution control systems necessary to comply with these EPA regulations.
     MedSolutions’ business strategy and expansion plans will place significant strain on its management, working capital, financial and management control systems and staff in the event that the merger does not occur. MedSolutions’ failure to properly respond to these needs by failing to maintain or upgrade financial and management control systems, failing to recruit additional staff or failing to respond effectively to difficulties encountered during expansion could adversely affect its business, financial condition and results of operations. Based on its experience in the industry, MedSolutions believes that its management and financial systems and controls are adequate to address current needs. There can be no

84


Table of Contents

assurance, however, that MedSolutions’ systems, controls or staff will be adequate to sustain future growth.
Acquisitions and Corporate Background
     BMI Services, Inc (“BMI”). BMI, a regulated medical waste and transportation management company, was acquired by EMSI in April 1996. BMI was based in Houston, Texas and was one of the largest independent transporters of medical waste in Texas. MedSolutions acquired its primary waste transportation business, its transfer station in Tyler, Texas and the UTMB arrangement through the BMI acquisition.
     EnviroClean Management Services, Inc (“EMSI”). MedSolutions formed EMSI in February 1996, as a consolidation vehicle for the merger or acquisition of BMI and other proposed entities. In January 1998, MedSolutions exchanged shares of its common stock to acquire 667,375 shares of EMSI from other shareholders. This transaction gave MedSolutions a controlling interest of approximately 51.3% of EMSI. In December 1998, MedSolutions offered to exchange one share of its common stock for each share of EMSI still outstanding. As a result, MedSolutions acquired shares representing an aggregate of 96.1% of EMSI’s stock. Since then MedSolutions has continued the exchange offer and has acquired additional shares and now owns 100% of EMSI.
     AmeriTech Environmental, Inc. (“ATE”). On November 7, 2003, MedSolutions acquired certain of the assets of ATE, including the assignment by ATE to MedSolutions of all of its regulated medical waste disposal customer contracts (which covered approximately 800 customers). The other assets acquired consisted primarily of equipment associated with ATE’s regulated medical waste disposal business and a parcel of real property permitted as a transfer site located in Houston, Texas. The purchase price for the acquired assets was $650,000 cash, a promissory note in the original principal amount of $750,000 bearing interest at a rate per annum of 7%, interest payable monthly, and all principal and accrued interest due on November 7, 2004, and 705,072 shares of MedSolutions common stock. The cash portion of the purchase price was funded from the proceeds of sales of MedSolutions common stock in private placements and $400,000 which was loaned to MedSolutions by two of its directors in exchange for promissory notes. The purchase price was determined largely based upon the amount of revenues ATE had generated from its regulated medical waste disposal business during the first three quarters of 2003.
     During 2004 and in accordance with the acquisition agreement, MedSolutions calculated a purchase price adjustment with respect to the customer list acquired from ATE. The calculation resulted in a purchase price reduction of $254,433, which lowered the assigned value of the customer list acquired. In addition, MedSolutions further determined there was an impairment of $139,330 in 2004 to the customer list acquired from ATE. Accordingly, MedSolutions recorded a charge of $139,330 during 2004, to reflect the decrease in net carrying value of the customer list. As part of the acquisition, MedSolutions also recorded goodwill of approximately $1,000,000.
     A settlement was reached between ATE and MedSolutions on February 11, 2005 due to numerous disputes and disagreements that arose in relation to ATE’s representations in the asset purchase agreement. The settlement called for the modification of the promissory note to ATE from MedSolutions to reduce the amount owed from $750,000 to $150,000, payable in two installments of $75,000 each beginning at the time that ATE delivered audited financial statements of its books and records for the nine-month period ended September 30, 2003 allowing MedSolutions to comply with its Form 8-K reporting requirements with the SEC. MedSolutions recorded a reduction (included in other income) of debt of approximately $650,000 during the three months ended March 31, 2005 for compensatory damages that resulted from breaches committed by ATE. Since the February 11, 2005 settlement was reached, ATE could not deliver audited financial statements as required; therefore, the settlement

85


Table of Contents

agreement was amended so that the remaining balance of $150,000 owed to ATE was converted into 150,000 shares of the MedSolutions common stock and all remaining disputes with ATE were settled.
     Bray Medical Waste Service (“Bray”). On January 1, 2004, MedSolutions acquired the customer contracts and took over the regulated medical waste operations of Bray. The purchase price for the acquired assets was (i) $11,200 cash and (ii) 29,867 shares of MedSolutions common stock valued at $22,400 for a total purchase price of $33,600. The purchase price allocation was $30,000 to customer list and $3,600 to goodwill.
     Med-Con Waste Solutions, Inc. (“Med-Con”). On September 30, 2004, MedSolutions acquired certain assets, including a customer list, of Med-Con in an acquisition accounted for as a purchase for a total purchase price of $1,149,000. The purchase price for the acquired assets was (i) $250,000 cash, (ii) a promissory note in the original principal amount of $500,000 bearing interest at a rate per annum of 7%, payable in 30 equal monthly installments of principal and interest with the first such installment due on January 1, 2005, (iii) a promissory note in the original principal amount of $250,000, with no interest, and with the principal amount and the due date subject to adjustment based upon the delivery by Med-Con to MedSolutions of consents to the assignment of the customer contracts acquired from Med-Con within 75 days of the closing of the transaction, (iv) and 149,000 shares of MedSolutions common stock. The principal amount of the $500,000 promissory note was subject to adjustment depending upon the amount of revenues realized by MedSolutions from the customer contracts acquired from Med-Con for the ensuing 90 days following the closing of the transaction. MedSolutions assigned $497,610, based on an independent appraisal, to the customer list acquired and established a useful life of five years over which to amortize the assigned cost. Amortization expense of the customer list for each year will approximate $99,522.
     During the year ended December 31, 2004 and in accordance with the acquisition agreement, MedSolutions calculated a purchase price adjustment of $153,780, which lowered the assigned value of the assets acquired. This reduction reduced the note payable to Med-Con by $153,780.
     As part of the acquisition, MedSolutions also recorded goodwill of approximately $499,610, net of the purchase price reduction.
     On May 18, 2005, MedSolutions and Med-Con restructured the two notes payable that were in default. The agreement called for the $346,220 note (originally $500,000) plus accrued interest of $10,000 to be paid in 48 equal monthly payments of $8,896, and an increase of the original interest rate from seven percent (7%) to eight (8%). With regard to the second note of $145,000 (originally $250,000), the agreement called for 24 equal monthly installments of $6,691 with the note bearing interest at ten percent (10%). In accordance with EITF 96-19, Debtor’s Accounting for a Modification or Exchange of Debt Instruments, the modification to the debt agreement was not determined to be a substantial modification.
     On Call Medical Waste Service (“On Call”). On August 29, 2005, MedSolutions acquired certain assets including customer contracts from On Call for a total purchase price of $1,155,500. The purchase price for the acquired assets was (i) $375,000 cash, (ii) a promissory note in the original principal amount of $250,000 bearing interest at a rate per annum of 8%, payable in 24 equal monthly installments of principal and interest with the first such installment due on December 27, 2005, (iii) a promissory note in the original principal amount of $375,000 with no interest, (iv) 166,667 shares of MedSolutions common stock, and (v) $30,500 of transaction costs incurred by MedSolutions. The cash portion of the purchase price was funded from the proceeds of a sale of MedSolutions common stock in a private placement to, and a loan to MedSolutions pursuant to a promissory note from, one of its shareholders.

86


Table of Contents

     Cooper Biomed, Ltd. (“Cooper”). On September 30, 2005, MedSolutions acquired certain assets, principally customer contracts, from Cooper for a total purchase price of $120,000. The purchase price for the acquired assets was (i) $40,000 cash, (ii) a promissory note in the original principal amount of $40,000 with no interest, (iii) a promissory note in the original principal amount of $25,000, without interest, payable in one installment of principal in the amount of $25,000 due on the 120th day after the closing date of the acquisition subject to adjustment, (iv) 10,000 shares of MedSolutions common stock, and (v) $5,000 of transaction costs incurred by MedSolutions. The purchase price was allocated to customer list ($114,505) and to accounts receivable ($5,495). The cash portion of the purchase price was funded from the proceeds of a sale of MedSolutions common stock in a private placement to, and a loan to MedSolutions pursuant to a promissory note from, one of its shareholders. As provided for in the agreement MedSolutions calculated a $8,500 purchase price adjustment and reduced the principal due under the $25,000 promissory note and the amount assigned to customer list, accordingly.
     Positive Impact Waste Solutions, LLC (“PIWS”). On November 30, 2005, MedSolutions acquired certain assets, including customer contracts for approximately 250 PIWS customers plus six mobile treatment units, and took over the regulated medical waste operations of PIWS for a purchase price of $1,820,000. The purchase price for the acquired assets was (i) $700,000 cash, (ii) a promissory note in the original principal amount of $300,000 bearing no interest and payable in three equal installments of principal in the amount of $100,000 each, with the first such installment due on March 30, 2006, the second such installment due on July 28, 2006, and the third such installment due on November 30, 2006, (iii) a promissory note in the original principal amount of $550,000, bearing interest at the annual rate of 8%, and payable in six equal installments of interest only in the amount of $3,666.66 each due monthly beginning on December 30, 2005, and 54 monthly installments of principal and interest in the amount of $12,161.83 each thereafter; (iv) and 360,000 shares of MedSolutions common stock. The cash portion of the purchase price was funded from the proceeds of a sale of MedSolutions common stock in a private placement to, and a loan to MedSolutions pursuant to a promissory note from, one of its shareholders, and loans from two additional shareholders. The purchase price was determined largely based upon the amount of revenues PIWS has generated from its regulated medical waste disposal business and the value of the equipment acquired. Pursuant to the asset purchase agreement and the transaction documents related thereto, PIWS granted MedSolutions the exclusive right to service customers located within the States of Texas and Kansas with PIWS’ mobile treatment units, and also granted MedSolutions certain rights of first refusal with respect to such exclusive right in additional states.
     Subsequent to MedSolutions’ acquisition of PIWS’ assets, it was determined that PIWS had not complied with certain terms of the asset purchase agreement. On June 30, 2006, a settlement was reached and executed between MedSolutions and PIWS relating to such noncompliance. As a result of this noncompliance and in accordance with the terms of the asset purchase agreement, a reduction of the total purchase price by $169,000 was agreed to by both parties. The purchase price adjustment reduced the amount assigned to customer list by $169,000.
     SteriLogic Waste Systems, Inc. On August 16, 2006, MedSolutions acquired SteriLogic Waste Systems, Inc., a Pennsylvania corporation (“SteriLogic”) located in Syracuse, New York. SteriLogic is a regulated medical waste management company that provides collection, transportation and disposal of regulated medical waste services in addition to providing a reusable sharps container program to its customers who are primarily located in the states of New York and Pennsylvania. SteriLogic also designs, manufactures and markets reusable sharps containers to medical waste service providers who provide a reusable sharps container program to their medical waste customers. The acquisition was effected by the merger of SteriLogic with and into a wholly-owned subsidiary of MedSolutions. At the effective time of the merger, each share of SteriLogic common stock issued and outstanding immediately prior to such time was converted into the right to receive 200 shares of MedSolutions common stock, for an aggregate of 1,000,000 shares. In addition, MedSolutions paid the sole shareholder of SteriLogic (i) $50,000 in

87


Table of Contents

readily available funds, and (ii) a convertible promissory note in the principal amount of $250,000 with simple interest at the annual rate of 8% accruing from the effective time and payable in 12 equal installments of interest only in the amount of $1,666.67 each due monthly beginning on the 30th day after the effective time, and 24 equal installments of principal and interest in the amount of $11,306.82 each due monthly thereafter. The unpaid principal and interest under such note was convertible at any time on or prior to August 16, 2007 into shares of the MedSolutions common stock at the conversion price $1.50 per share (subject to certain anti-dilution adjustments). The merger consideration may be adjusted downward depending upon the amount of sales or earnings realized by MedSolutions from the customer contracts acquired through the acquisition of SteriLogic for the twelve months following the closing of the transaction. Any such adjustment to the merger consideration will be deducted 25% from the principal amount of the $250,000 promissory note, and 75% from the shares of MedSolutions common stock issued in connection with the merger at the rate of $1.50 per share; provided, that MedSolutions may not deduct more than 400,000 of such shares with respect to the adjustment. The cash portion of the merger consideration was funded from working capital. The merger consideration was determined largely based upon the amount of revenues SteriLogic had generated from its regulated medical waste disposal business and the value of the net assets acquired.
     On January 15, 2007, MedSolutions and the former owners of SteriLogic agreed by mutual consent to amend the original merger agreement whereby the former owners of SteriLogic agreed to reduce the number of shares of MedSolutions common stock issued by MedSolutions from 1,000,000 to 700,000 shares and to terminate the conversion feature of the $250,000 promissory note issued by MedSolutions as part of the purchase price. As a result of these amendments, MedSolutions recorded a reduction in the purchase price with regard to the SteriLogic acquisition by $264,000 reflecting the return of the 300,000 shares issued by MedSolutions. The corresponding reduction reduced the value assigned to SteriLogic’s customer list by $264,000.
Expansion Plans and Acquisition Targets
     MedSolutions has been issued a treatment permit by the Oklahoma Department of Environmental Quality (“ODEQ”) for its transfer site in Oklahoma City. MedSolutions subleases a facility and has a first right of refusal on a site in Odessa, Texas that has been issued a permit by the Texas Commission on Environmental Quality (the “TCEQ”) for the treatment of medical waste. MedSolutions has also submitted applications to treat regulated medical waste in Kansas City, Kansas and Syracuse, New York. These permits should allow MedSolutions to more effectively service the upper New York, Northern Pennsylvania, Oklahoma, Kansas, Missouri and West Texas markets. MedSolutions has currently ceased discussions with potential acquisition and/or merger candidates pending completion of the merger. However, in the event that the merger does not occur, MedSolutions may renew various discussions with potential acquisition and/or merger candidates to densify and/or expand the markets it services.
     Evaluation and Integration. MedSolutions believes that its management team can evaluate potential acquisition candidates and determine whether a particular medical waste management business can be successfully integrated into MedSolutions’ business. In determining whether to proceed with a business acquisition, MedSolutions will evaluate a number of factors including:
    the financial impact of the proposed acquisition, including the effect on MedSolutions’ cash flow and earnings per share;
 
    the historical and projected financial results of the target company;
 
    the purchase price negotiated with the seller and MedSolutions’ expected internal rate of return;

88


Table of Contents

    the structure of the purchase with regard to offering one or the combination of the following: cash, notes and stock;
 
    the composition and size of the target company’s customer base and the opportunity value of integrating MedSolutions’ service, ancillary service and regulatory compliance programs into the target company’s market;
 
    the efficiencies that MedSolutions can achieve by integrating the target company with its existing operations;
 
    the potential for enhancing or expanding MedSolutions’ geographic service area and allowing MedSolutions to make other acquisitions in the same service area;
 
    the experience, reputation and personality of the target company’s management;
 
    the target company’s reputation for customer service and relationships with the communities that it serves; and
 
    whether the acquisition gives MedSolutions any strategic advantages over its competition.
     Once a business is acquired, MedSolutions will implement programs designed to improve customer service, sales, marketing, routing, equipment utilization, employee productivity, operating efficiencies and cash flow.
Marketing and Sales
     Marketing Strategy. MedSolutions uses both telemarketing and direct sales efforts to obtain new customers. In addition, MedSolutions has a large database of potential new large and small quantity generators, which it believes gives it a competitive advantage in identifying and reaching these higher-margin accounts. MedSolutions’ drivers participate in its marketing and sales efforts by actively soliciting small quantity generators while they service their routes.
     Small Quantity Generators (“SQG”). MedSolutions has targeted SQG’s as a growth area. MedSolutions believes that these customers offer high profit potential compared to other potential customers. Typical small quantity generators are individual or small groups of doctors, dentists and other healthcare providers who are widely dispersed and generate only small amounts of medical waste. These customers are very concerned about having the medical waste picked up and disposed of in compliance with applicable state and federal regulations. MedSolutions believes that these customers view the potential risks of non-compliance with applicable state and federal medical waste regulations as disproportionate to the cost of the services that MedSolutions provides. MedSolutions believes that this factor has been the basis for the significantly higher gross margins that it has achieved with its SQG’s as opposed to its LQG’s. In addition, MedSolutions’ EnviroSafe program offers a total compliance solution that combines medical waste management, OSHA and HIPPA compliance and training in one simple program. EnviroSafe guarantees small account customers who abide by its training, counsel and advice that they will have protection from regulatory compliance issues.
     Medium Quantity Generators (“MQG”). The medium quantity generators segment of MedSolutions’ business currently provides it with the opportunity for substantial growth and better profit margins than LQG’s. These customers are typically blood banks, dialysis centers, surgery centers and other high volume specialty facilities.
     Large Quantity Generators (“LQG”). MedSolutions believes that it has been successful in servicing LQG’s and plans to continue to serve those customers as long as they establish route anchors that open

89


Table of Contents

the door for opportunities for MedSolutions’ ancillary services and/or maintain satisfactory levels of profitability. In addition, MedSolutions believes that the implementation of more stringent Clean Air Act and other federal regulations directly and indirectly affecting medical waste will enable it to improve its marketing efforts to large quantity generators because the additional costs that they will incur to comply with these regulations will make the costs of MedSolutions’ services more attractive, particularly relative to their use of their own incinerators. MedSolutions’ marketing and sales efforts to large quantity generators are conducted by full-time account executives whose responsibilities include identifying and attracting new customers and serving MedSolutions’ existing account base of large quantity generators. In addition to securing new contracts, MedSolutions’ marketing and sales personnel provide consulting services to its healthcare customers, assisting them in reducing the amount of medical waste that they generate, training their employees on safety issues and implementing programs to audit, classify and segregate medical waste in a proper manner.
     Contract and Service Agreements. MedSolutions has long-term contracts with substantially all of its customers. MedSolutions negotiates individual service agreements with each large quantity and small quantity generator. Although MedSolutions has a standard form of agreement, particularly for small quantity generators, terms may vary depending upon the customer’s service requirements and the volume of medical waste generated and, in some jurisdictions, requirements imposed by statute or regulation. Service agreements typically include provisions relating to the types of containers, frequency of collection, pricing, treatment and documentation for tracking purposes. Each agreement also specifies the customer’s obligation to pack its medical waste in approved containers. Substantially all of MedSolutions’ agreements with customers contain automatic renewal and price increase provisions.
     Service agreements are generally for a period of one to five years, although customers may terminate on written notice and, in most cases, upon payment of a penalty. MedSolutions may set its prices on the basis of the number of containers that it collects, the weight of the medical waste that it collects and treats, the number of collection stops that it makes on the customer’s route, the number of collection stops that it makes for a particular multi-site customer, and other factors.
     Competition. There are several regulated medical waste management companies operating in MedSolutions’ service areas and the surrounding regions, and the market is highly competitive. MedSolutions’ primary competitor is Stericycle. Stericycle provides a variety of services other than collection, transportation, treatment and disposal. As such, Stericycle has a larger scope of business opportunities and substantially greater financial resources than MedSolutions possesses.
     According to public filings, Stericycle is the largest medical waste management company in the United States. Stericycle initially developed and utilized a proprietary electro-thermal deactivation (“ETD”) process in a national strategy. However, Stericycle, like MedSolutions, primarily utilizes autoclave technologies to process a majority of its waste stream and to a lesser degree incineration technologies.
     In the event that the merger does not occur, based on its experience in the industry, MedSolutions believes that it can successfully compete with Stericycle and other competitors by concentrating its operations in the southern and northeastern portions of the United States. MedSolutions believes that it gains a competitive advantage by offering better customer service than its competitors, attractive ancillary services and regulatory compliance programs and, if necessary, the ability to reduce the price of waste disposal services to customers to an amount below that of MedSolutions’ competitors. MedSolutions believes this can be accomplished as a result of having its facilities in closer geographic proximity to the generators of medical waste, its cost reduction efforts, its ability to offer ancillary services and programs and the expansion of its operations through acquisitions.

90


Table of Contents

     In addition, MedSolutions faces potential competition from businesses that are attempting to commercialize alternate treatment technologies or products designed to reduce or eliminate the generation of medical waste, such as reusable or degradable medical products.
     MedSolutions competes for service agreements primarily on the basis of cost-effectiveness, quality of service and geographic location. MedSolutions also attempts to compete by demonstrating to customers that it can do a better job in reducing their potential liability. MedSolutions’ ability to obtain new service agreements may be limited by the fact that a potential customer’s current vendor may have an excellent service history or a long-term service contract or may offer prices to the potential customer that are lower than MedSolutions’.
Competitive Strengths
     MedSolutions believes that it benefits from the following competitive strengths:
     Broad Range of Services. MedSolutions offers its customers a broad range of services to help them develop internal systems and processes, which allow them to manage their medical waste, sharps containers and PHI destruction efficiently and safely from the point of generation through treatment and disposal. MedSolutions has also developed regulatory compliance programs to help train its customers’ employees on the proper methods of handling medical waste in order to reduce potential employee exposure. Other regulatory compliance programs such as MedSolutions’ EnviroSafe Program include those designed to help clients ensure and maintain compliance with OSHA, HIPAA and other relevant regulations.
     Strong Sales Network and Proprietary Database. MedSolutions uses both telemarketing and direct sales efforts to obtain new customers. In addition, MedSolutions has a large database of potential new small and large quantity generators, which it believes gives it a competitive advantage in identifying and reaching these higher-margin and route anchor accounts.
     Experienced Senior Management Team. MedSolutions’ senior executives collectively have over 50 years of management experience in the waste management and healthcare industries.
Governmental Regulation
     MedSolutions is subject to extensive and frequently changing federal, state and local laws and regulations. This statutory and regulatory framework imposes compliance burdens and risks on MedSolutions, including requirements to obtain and maintain government permits. These permits grant MedSolutions the authority, among other things:
    to construct and operate treatment and transfer facilities;
 
    to transport medical waste within and between relevant jurisdictions; and
 
    to handle particular regulated substances.
     MedSolutions’ permits must be periodically renewed and are subject to modification or revocation by the regulatory authorities. MedSolutions is also subject to regulations that govern the definition, generation, segregation, handling, packaging, transportation, treatment, storage and disposal of medical waste. MedSolutions is also subject to extensive regulations designed to minimize employee exposure to medical waste.

91


Table of Contents

     Federal Regulation. There are at least four federal agencies that have authority over medical waste. These agencies are the EPA, OSHA, the DOT and the U.S. Postal Service. These agencies regulate medical waste under a variety of statutes and regulations.
     Medical Waste Tracking Act of 1988. In the late 1980s, the EPA outlined a two-year demonstration program pursuant to MWTA, which was added to the Resource Conservation and Recovery Act of 1976. The MWTA was adopted in response to health and environmental concerns over infectious medical waste after medical waste washed ashore on beaches, particularly in New York and New Jersey, during the summer of 1988. Public safety concerns grew following media reports of careless management of medical waste. The MWTA was intended to be the first step in addressing these problems. The primary objective of the MWTA was to ensure that medical wastes which were generated in a covered state and which posed environmental problems, including an unsightly appearance, were delivered to disposal or treatment facilities with minimum exposure to waste management workers and the public. The MWTA’s tracking requirements included accounting for all waste transported and imposed civil and criminal sanctions for violations.
     In regulations implementing the MWTA, the EPA defined medical waste and established guidelines for its segregation, handling, containment, labeling and transport. The MWTA demonstration program expired in 1991, but the MWTA established a model followed by many states in developing their specific medical waste regulatory frameworks.
     Occupational Safety and Health Act of 1970. The Occupational Safety and Health Act of 1970 authorizes OSHA to issue occupational safety and health standards. OSHA regulations are designed to minimize the exposure of employees to hazardous work environments. Various standards apply to certain aspects of MedSolutions’ operations. These regulations govern, among other things:
    exposure to blood borne pathogens and other potentially infectious materials;
 
    lock out/tag out procedures;
 
    medical surveillance requirements;
 
    use of respirators and personal protective equipment;
 
    emergency planning;
 
    hazard communication;
 
    noise;
 
    ergonomics; and
 
    forklift safety.
     MedSolutions’ employees are required by its policy to receive new employee training, annual refresher training and training in their specific tasks. As part of MedSolutions’ medical surveillance program, employees receive pre-employment physicals, including drug testing, annually required medical surveillance and exit physicals. MedSolutions also subscribes to a drug-free workplace policy. In addition, MedSolutions is subject to unannounced OSHA Safety inspections at any time.
     Resource Conservation and Recovery Act of 1976. In 1976, Congress passed the Resource Conservation and Recovery Act of 1976, or RCRA, as a response to growing public concern about problems associated with the handling and disposal of solid and hazardous waste. RCRA required the EPA to promulgate regulations identifying hazardous wastes. RCRA also created standards for the generation, transportation, treatment, storage and disposal of solid and hazardous wastes. These standards

92


Table of Contents

included a documentation program for the transportation of hazardous wastes and a permit system for solid and hazardous waste disposal facilities. Medical wastes are currently considered non-hazardous solid wastes under RCRA. However, some substances collected by MedSolutions from some of its customers, including photographic fixer developer solutions, lead foils and dental amalgam, are considered hazardous wastes.
     MedSolutions uses landfills operated by parties unrelated to it for the disposal of incinerator ash, autoclaved and chemically treated waste.
     Waste is not regulated as hazardous under RCRA unless it contains hazardous substances exceeding certain quantities or concentration levels, meets specified descriptions, or exhibits specific hazardous characteristics. Following autoclave treatment, waste is disposed of as non-hazardous waste. After incineration treatment, MedSolutions tests ash from the incineration process to determine whether it must be disposed of as hazardous waste.
     MedSolutions employs quality control measures to check incoming medical waste for specific types of hazardous substances. MedSolutions’ customer agreements also require its customers to exclude different kinds of hazardous substances or radioactive materials from the medical waste they provide MedSolutions.
     DOT Regulations. The DOT has put regulations into effect under the Hazardous Materials Transportation Authorization Act of 1994 which require MedSolutions to package and label medical waste in compliance with designated standards, and which incorporate blood borne pathogens standards issued by OSHA. Under these standards, MedSolutions must, among other things, identify its packaging with a “biohazard” marking on the outer packaging, and MedSolutions’ medical waste container must be sufficiently rigid and strong to prevent tearing or bursting and must be puncture-resistant, leak-resistant, properly sealed and impervious to moisture.
     DOT regulations also require that a transporter be capable of responding on a 24-hour-a-day basis in the event of an accident, spill, or release to the environment of a hazardous material. MedSolutions has entered into an agreement with an organization that provides 24-hour emergency spill response to provide this service.
     MedSolutions’ drivers are trained on topics such as safety, hazardous materials, medical waste, hazardous chemicals and infectious substances. Employees are trained to deal with emergency spills and releases of hazardous materials, and MedSolutions has a written contingency plan for these events. MedSolutions’ vehicles are outfitted with spill control equipment and the drivers are trained in its use.
     Comprehensive Environmental Response, Compensation and Liability Act of 1980. The Comprehensive Environmental Response, Compensation and Liability Act of 1980, or CERCLA, established a regulatory and remedial program to provide for the investigation and cleanup of facilities that have released or threaten to release hazardous substances into the environment. CERCLA and state laws similar to it may impose strict, joint and several liability on the current and former owners and operators of facilities from which releases of hazardous substances have occurred and on the generators and transporters of the hazardous substances that come to be located at these facilities. Responsible parties may be liable for substantial site investigation and cleanup costs and natural resource damages, regardless of whether they exercised due care and complied with applicable laws and regulations. If MedSolutions were found to be a responsible party for a particular site, it could be required to pay the entire cost of the site investigation and cleanup, even though other parties also may be liable. This result would be the case if MedSolutions were unable to identify other responsible parties, or if those parties were financially unable to contribute money to the cleanup.

93


Table of Contents

     State and Local Regulation. MedSolutions currently conducts all of its business in Texas, Oklahoma, Louisiana, Arkansas, Kansas, Missouri, New York and Pennsylvania. In the event that the merger does not occur, at some point in the future, MedSolutions may conduct business in other states. Other states have different regulations regarding medical waste, medical waste transport and medical waste incineration. If at any time MedSolutions expands its business into other states, MedSolutions believes, because of the stringent standards applicable in the states MedSolutions currently operates, that the costs of bringing its business into compliance with the regulations of other states will be minimal.
     Regulated Medical Waste. The Texas Department of Health retains authority to define what waste will be regulated and how it may be treated. These rules, which were updated in December 1994, can be found in Title 25 Texas Administrative Code (“TAC”) Sections 1.131-1.137. Under Texas law, the term “special waste from health-care facilities” (“SWFHCRF”) is used to define medical waste regulated by state agencies. Only five categories of waste are regulated:
    animal waste from animals intentionally exposed to pathogens;
 
    bulk human blood and blood products;
 
    pathological waste;
 
    microbiological waste; and
 
    sharps.
     The criteria for selection of these categories were based primarily on environmental concerns rather than occupational concerns. A chain of events is necessary to produce disease from contact with medical waste. The items selected for regulation were deemed to have the highest potential for disease production provided all of the required events took place. Sharps, due to their inherent ability to provide a portal of entry, must be managed properly regardless of their contamination status.
     Transportation of Regulated Medical Waste. Subchapter Y, 30 TAC § 330.1001-1010 defines rules for medical waste management, disposal, transportation, collection and storage. These rules were updated in December 2006. The responsibility for these regulations rests with the Office of Waste Management of the TCEQ. Under Subchapter Y, the TCEQ regulates and registers transporters of medical waste by, among other things, requiring specific documentation of transportation of all medical waste. Currently, MedSolutions is a registered medical waste transporter. The registration is subject to annual renewal, and though MedSolutions believes, based on its experience in the industry, that it is in compliance with all of the statutory guidelines, there is no guarantee that the TCEQ will continually grant renewal registration to MedSolutions. MedSolutions is also registered as a medical waste transporter in the states of Louisiana, Oklahoma, Kansas Missouri, Arkansas, New York and Pennsylvania.
     Treatment of Regulated Medical Waste. Approved methods of treatment of SWFHCRF can be found in Title 25 TAC Section 1.133. There are currently six approved treatment methods:
    steam disinfection;
 
    chlorine disinfection/maceration;
 
    chemical disinfection;
 
    moist disinfection;
 
    thermal inactivation; and

94


Table of Contents

    incineration.
     MedSolutions employs the steam disinfection (i.e. autoclave), chemical disinfection and incineration methods for the treating of medical waste. MedSolutions has been successful in obtaining permits for its current medical waste transfer, treatment and processing facilities and for its transportation operations. Currently, MedSolutions operates two autoclaves at its Garland facility.
     MedSolutions is responsible for complying with the maintenance obligations pursuant to numerous governmental permits and licenses held by it or under which it conducts its business. MedSolutions is also responsible for complying with permits maintained by others. These permits include:
    transport permits for solid waste, medical waste and hazardous substances;
 
    permits to construct and operate treatment facilities;
 
    permits to construct and operate transfer stations;
 
    permits governing discharge of sanitary water and registration of equipment under air regulations;
 
    approvals for the use of ETD and other technologies to treat medical waste; and
 
    various business operator’s licenses.
     MedSolutions believes that it is currently in compliance in all material respects with its permits and applicable laws and regulations. If MedSolutions expands its services to other states, it will have to comply with such state’s specific permitting process to obtain the necessary permits to operate in such state, including, but not limited to obtaining zoning approval and local and state operating authority. Most communities rely on state authorities to provide operating rules and safeguards for their community. Usually the state provides public notice of the project and, if enough public interest is shown, a public hearing may be held. If the applicant is successful in meeting all regulatory requirements, the state may issue a permit to construct the new treatment facility or transfer station. Once the facility is constructed, the state may again issue public notice of its intent to issue an operating permit and may provide an opportunity for public opposition or other action that may impede the applicant’s ability to construct or operate the planned facility. Permitting for transportation operations frequently involves registration of vehicles, inspection of equipment, and background investigations on MedSolutions’ drivers.
Patents and Proprietary Rights
     MedSolutions relies on unpatented and unregistered trade secrets, proprietary know-how and continuing technological innovation. MedSolutions tries to protect this information, in part, by confidentiality agreements with its employees, vendors and consultants. There can be no assurance that these agreements will not be breached, that MedSolutions would have adequate remedies for any breach, or that it trade secrets or know-how will not otherwise become known or independently discovered by other parties.
     MedSolutions’ commercial success may also depend on its not infringing patents issued to other parties. There can be no assurance that patents belonging to other parties will not require MedSolutions to alter its processes, pay licensing fees, or cease using any current or future processes. In addition, there can be no assurance that MedSolutions would be able to license the technology rights that it may require at a reasonable cost or at all. If MedSolutions could not obtain a license to any infringing technology that it currently uses, it could have a material adverse effect on MedSolutions’ business.

95


Table of Contents

Potential Liability and Insurance
     The medical waste industry involves potentially significant risks of statutory, contractual, tort and common law liability claims. Potential liability claims could involve, for example:
    cleanup costs;
 
    personal injury;
 
    damage to the environment;
 
    employee matters;
 
    property damage; or
 
    alleged negligence or professional errors or omissions in the planning or performance of work.
     MedSolutions could also be subject to fines or penalties in connection with violations of regulatory requirements.
     MedSolutions carries $10 million of liability insurance (including umbrella coverage), and $5 million of aggregate pollution and legal liability insurance ($1 million per incident), which it considers sufficient to meet regulatory and customer requirements and to protect its employees, assets and operations. MedSolutions’ pollution liability insurance excludes liabilities under CERCLA. There can be no assurance that MedSolutions will not face claims under CERCLA or similar state laws resulting in substantial liability for which it is uninsured and which could have a material adverse effect on MedSolutions’ business.
Employees
     As of June 30, 2007, MedSolutions, primarily through EMSI, had 141 employees. Five of the employees are employed in executive capacities; the remaining employees are in transportation and plant operations, sales positions and administrative and clerical capacities. None of MedSolutions’ employees are subject to collective bargaining agreements.
Description of Property
     MedSolutions leases approximately 6,800 square feet of administrative office space at 12750 Merit Drive-Park Central VII, Suite 770, Dallas, Texas 75251. The lease expires May 31, 2012, and the monthly rent ranges from $8,100 to $10,000 through 2012.
     MedSolutions owns its Garland facility, which consists of real property, building and improvements, furniture and equipment. The Garland facility includes 17,450 square feet of space (2,450 square feet of office space and 15,000 square feet of warehouse space), and is located on approximately three acres of land. The building is approximately 30 years old, and was extensively remodeled in 1996 at a cost of more than $500,000 to upgrade the facility to accommodate the EnviroClean® System and to showcase its operation for sales and marketing purposes. The EnviroClean® System was removed during 2004 in order to use the space in the Garland facility more efficiently for MedSolutions’ autoclave process. Prior to the installation of the autoclave in 2002, the Garland facility was used solely as a transfer station. MedSolutions’ bank debt is secured by a first lien on the Garland facility which is personally guaranteed by MedSolutions’ President/Chief Executive Officer, and two loans from MedSolutions shareholders are secured by second liens on the Garland facility. The net carrying value of the Garland facility is approximately $263,000.

96


Table of Contents

     MedSolutions owns its Houston facility, which consists of real property, building and improvements, furniture and equipment. The Houston facility includes approximately 7,500 square feet of administrative office and warehouse space in Houston, Texas. MedSolutions, through its subsidiary EMSI, purchased the Houston facility on August 3, 2005. The facility was previously being leased and was contiguous to vacant land that was already owned by EMSI and was being used as a transfer station. The total purchase price, including transaction costs, was approximately $350,000 and is financed by a promissory note to a bank in the amount of $325,000, payable in 60 monthly installments of $3,656 based upon a straight line amortization of 240 payments and accrues interest per annum at the prime rate as published in the Wall Street Journal from time to time plus 2%. The promissory note has a maturity date of August 3, 2010 and is secured by a first lien deed of trust on the building and the adjacent land already owned by EMSI. The promissory note is personally guaranteed by MedSolutions’ President/Chief Executive Officer.
     On August 9, 2006, MedSolutions, through its subsidiary EMSI, secured additional financing from a bank to expand its Houston facility. The facility is currently being used as a transfer facility for the South Texas operations. The expansion will allow EMSI to treat medical waste at the facility once the permitting process is completed from the state of Texas. The total costs of expansion will be approximately $275,000 with $200,000 of those funds coming from bank financing and the remainder from working capital. The promissory note to the bank is payable in 60 monthly installments of $822 in principal plus interest accruing at the prime rate as published in the Wall Street Journal from time to time plus 1%, with the balance of the principal and all accrued and unpaid interest due upon maturity of the loan on July 19, 2011. The note is secured by a second lien on the Houston facility and is personally guaranteed by both MedSolutions’ President/Chief Executive Officer and MedSolutions’ Chairman of the Board. As of December 31, 2006, MedSolutions has drawn $55,634 against the promissory note and the funds were used for the commencement phase of expansion. The amount outstanding at December 31, 2006 is $52,347 and the net carrying value of the Houston facility is approximately $370,000.
     In the opinion of MedSolutions’ management, its properties are adequately covered by insurance.
Legal Proceedings
     MedSolutions operates in a highly regulated industry and is exposed to regulatory inquiries or investigations from time to time. Government authorities can initiate investigations for a variety of reasons. MedSolutions has been involved in certain legal and administrative proceedings that have been settled or otherwise resolved on terms acceptable to MedSolutions, without having a material adverse effect on its business.
     On May 14, 2007, a Texas jury found EMSI liable in connection for approximately $10.4 million in actual damages and $10 million in punitive damages in connection with a 2004 traffic accident involving one of EMSI’s trucks. On June 15, 2007, a judgment was entered in the amount of $15,005,245. On September 27, 2007, counsel for the parties to the lawsuit and EMSI’s insurance providers entered into a preliminary but binding agreement with respect to the material terms of the settlement of the lawsuit pursuant to Rule 11 of the Texas Rules of Civil Procedure. The material terms of the settlement provide for a cash payment by EMSI’s insurance providers to the plaintiff, and also requires EMSI to deliver an interest-free promissory note in the principal amount of $250,000 (the “settlement note”) to the plaintiff. The settlement note is only payable in the event that the merger closes, and will be due on the date that the principal amount of the promissory notes issuable by Stericycle to MedSolutions’ shareholders becomes payable (i.e., on the seventh anniversary of the effective time of the merger). Any funds as of such date remaining from the $125,000 to be placed in the shareholder representative escrow account will be remitted by the shareholder representative to the surviving corporation, which will apply such funds towards the amount due under the settlement note. The principal amount of the promissory notes will be reduced on a pro rata basis in an aggregate amount equal to the difference between $250,000 (the principal amount of the settlement note) and the amount remitted to the surviving corporation from the shareholder representative escrow account. The preliminary but binding agreement under Rule 11 of the Texas Rules of Civil Procedure contains the essential terms of the settlement that will be supplemented by a more thorough agreement containing appropriate releases and documentation of other terms consistent with such essential terms.

97


Table of Contents

     MedSolutions is also a party to various legal proceedings arising in the ordinary course of business. However, except as described above, there are no legal proceedings pending or, to MedSolutions’ knowledge, threatened against or that could adversely affect its financial condition or its ability to carry on its business.
Market for Common Equity and Related Shareholder Matters
     There is currently no public trading market for MedSolutions’ common stock.
     At October 8, 2007, the record date for the special meeting, MedSolutions had 26,458,446 shares of common stock outstanding and had approximately 750 shareholders of record.
     MedSolutions has no fixed dividend policy with respect to its common stock. MedSolutions’ Board of Directors is authorized to consider dividend distributions on MedSolutions’ common stock from time to time, upon its assessment of MedSolutions’ operating results, capital requirements and general financial condition and requirements. MedSolutions has not paid a dividend on its common stock since its inception. Pursuant to the Investment Agreement (the “Investment Agreement”) entered into by MedSolutions and Tate Investments, LLC (the “Investor”) on July 15, 2005, MedSolutions is prohibited from paying any dividends or making any distributions in cash or in kind on shares of its common stock until all of the common stock held by the Investor is registered with the SEC. The outstanding principal amount of the convertible debt issued by MedSolutions pursuant to the Investment Agreement was subsequently converted by the Investor into shares of MedSolutions common stock on March 30, 2007, and MedSolutions has no further obligations to the Investor under the promissory note issued in connection with the Investment Agreement.
     MedSolutions’ Series A 10% Convertible Preferred Stock (the “Series A Preferred Stock”) ranked senior to its common stock with respect to the payment of dividends, redemption, and payment and rights upon liquidation, dissolution or winding-up of the affairs of MedSolutions. At October 8, 2007, MedSolutions had zero shares of Series A Preferred Stock outstanding. All of MedSolutions’ previously issued and outstanding shares of Series A Preferred Stock were converted into shares of MedSolutions common stock on a one-for-one basis on or prior to March 31, 2007.
Equity Compensation Plan Information (as of December 31, 2006)
                         
                    Number of
                    securities
                    remaining
                    available for
    Number of           future issuance
    securities to be           under equity
    issued upon   Weighted-average   compensation
    exercise of   exercise price of   plans (excluding
    outstanding   outstanding   securities
    options, warrants   options, warrants   reflected in
    and rights (a)   and rights (b)   column (a)) (c)
Equity compensation plans approved by security holders
    1,328,796     $ 0.80       1,671,204  
Equity compensation plans not approved by security holders
                 
Total
    1,328,796     $ 0.80       1,671,204  

98


Table of Contents

Management’s Discussion and Analysis or Plan of Operation.
     The following discussion of the financial condition and results of operations of MedSolutions should be read in conjunction with “MedSolutions’ Historical Consolidated Financial Statements and Supplementary Data” and the notes to such financial statements included in this proxy statement/prospectus.
Background
     MedSolutions was incorporated in November 1993. MedSolutions provides regulated medical waste, reusable sharps containers and PHI collection, transportation and treatment services to its customers and related training and education programs and consulting services.
     MedSolutions’ revenues increased to $12,799,132 in 2006 from $9,415,558 in 2005. MedSolutions derives its revenues from services to three principal groups of customers: (i) outpatient clinics, medical and dental offices, biomedical companies, municipal entities, long-term and sub-acute care facilities and other smaller-quantity generators of regulated medical waste (“SQG”), (ii) blood banks, surgery centers, dialysis centers and other medium quantity generators of regulated medical waste (“MQG”) and (iii) hospitals, diagnostic facilities and other larger-quantity generators of regulated medical waste (“LQG”). Substantially all of MedSolutions’ services are provided pursuant to customer contracts specifying either scheduled or on-call regulated medical waste management services, or both. Contracts with small quantity generators generally provide for annual price increases and have an automatic renewal provision unless the customer notifies MedSolutions prior to completion of the contract. Contracts with medium quantity generators and large quantity generators, which may run for more than one year, typically include price escalator provisions, which allow for price increases generally tied to an inflation index or implemented at a fixed percentage. At December 31, 2006, MedSolutions served approximately 10,000 customers.
Critical Accounting Policies and Procedures
     MedSolutions’ discussion and analysis of its financial condition and results of operations are based upon its consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States. The preparation of these financial statements requires that MedSolutions make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses, and the related disclosure of contingent assets and liabilities (see Note 3 to MedSolutions’ consolidated financial statements for the fiscal year ended December 31, 2006 included within “MedSolutions’ Historical Consolidated Financial Statements and Supplementary Data” and the notes to such financial statements included in this proxy statement/prospectus). MedSolutions believes that of its significant accounting policies (see Note 3 to MedSolutions’ consolidated financial statements for the fiscal year ended December 31, 2006), the following may involve a higher degree of judgment on MedSolutions’ part and complexity of reporting:
     Accounts Receivable. Accounts receivable consist primarily of amounts due to MedSolutions from its normal business activities. MedSolutions maintains an allowance for doubtful accounts which reflects management’s best estimate of probable losses inherent in the account receivable balance. Management determines the allowance based on known troubled accounts, historical experience, and other currently available evidence. With respect to trade receivables, ongoing credit evaluations of customers’ financial condition are performed and generally, no collateral is required. MedSolutions maintains a reserve for potential credit losses and such losses, in the aggregate, have not exceeded management’s expectations.
     Revenue Recognition and Processing Costs. MedSolutions recognizes revenue for its medical waste services at the time the medical waste is collected from its customers. Revenue is only recognized for

99


Table of Contents

arrangements with customers in which (1) there is persuasive evidence of a contract or agreement which sets forth the terms of the arrangement; (2) services have been rendered; (3) MedSolutions’ prices are fixed, determinable and agreed upon; and, (4) collectibility is reasonably assured.
     Goodwill and Intangible Assets. To determine the adequacy of the carrying amounts on an ongoing basis, MedSolutions performs its annual impairment test at the end of the year each December 31, unless triggering events indicate that an event has occurred which would require the test to be performed sooner. MedSolutions monitors the performance of its intangibles by analyzing the expected future cash flows generated from such related intangibles to ensure their continued performance. If necessary, MedSolutions may hire an outside independent consultant to appraise the fair value of such assets.
     Convertible Notes and Convertible Preferred Stock. MedSolutions accounts for conversion options embedded in convertible notes and convertible preferred stock in accordance with Statement of Financial Accounting Standard (“SFAS) No. 133 “Accounting for Derivative Instruments and Hedging Activities” (“SFAS 133”) and EITF 00-19 “Accounting for Derivative Financial Instruments Indexed to, and Potentially Settled in, a Company’s Own Stock” (“EITF 00-19”). SFAS 133 generally requires companies to bifurcate conversion options embedded in convertible notes and preferred shares from their host instruments and to account for them as free standing derivative financial instruments in accordance with EITF 00-19. SFAS 133 provides for an exception to this rule when convertible notes and mandatorily redeemable preferred shares, as host instruments, are deemed to be conventional as that term is described in the implementation guidance provided in paragraph 61(k) of Appendix A to SFAS 133 and further clarified in EITF 05-2 “The Meaning of “Conventional Convertible Debt Instrument” in Issue No. 00-19. SFAS 133 provides for an additional exception to this rule when the economic characteristics and risks of the embedded derivative instrument are clearly and closely related to the economic characteristics and risks of the host instrument.
     MedSolutions accounts for convertible notes (deemed conventional) and non-conventional convertible debt instruments classified as equity under EITF 00-19 “Accounting for Derivative Financial Instruments Indexed to, and Potentially Settled in, a Company’s Own Stock” (“EITF 00-19”) and in accordance with the provisions of Emerging Issues Task Force Issue (“EITF”) 98-5 “Accounting for Convertible Securities with Beneficial Conversion Features,” (“EITF 98-5”), EITF 00-27 “Application of EITF 98-5 to Certain Convertible Instruments.” Accordingly, MedSolutions records, as a discount to convertible notes, the intrinsic value of such conversion options based upon the differences between the fair value of the underlying common stock at the commitment date of the note transaction and the effective conversion price embedded in the note. Debt discounts under these arrangements are amortized over the term of the related debt to their earliest date of redemption.
Results of Operations — Year 2006 Compared to 2005
     Revenues. MedSolutions’ revenues increased $3,383,574 or 35.9%, to $12,799,132 during the year ended December 31, 2006, from $9,415,558 during the year ended December 31, 2005. The increase in revenue from 2005 was mostly attributable to the three acquisitions in 2005 and the SteriLogic acquisition in 2006 which contributed approximately $2,600,000 of the 2006 revenue increase. Other contributing factors that caused the revenue increase in 2006 were an annual price increase in January 2006 to the majority of MedSolutions’ SQG customers and a fuel surcharge increase in March 2006. All price increases and fee charges are provided for under MedSolutions’ customer contracts. The increases in revenues for the twelve months ended December 31, 2006 were partially offset by a loss of revenue from an LQG customer in MedSolutions’ South Texas market and from the loss of its operating agreement with UTMB as discussed in Note 12 to MedSolutions’ consolidated financial statements for the fiscal year ended December 31, 2006 included within “MedSolutions’ Historical Consolidated Financial

100


Table of Contents

Statements and Supplementary Data” and the notes to such financial statements included in this proxy statement/prospectus.
     Cost of revenues. MedSolutions’ cost of revenues increased $2,244,707 or 39.5%, to $7,925,086 during 2006, from $5,680,379 in 2005. Gross margin for MedSolutions decreased to 38.1% in 2006 from 39.7% in 2005. The increase in cost of revenues was caused by increases in container costs resulting from higher prices for paper products, fuel and other transportation costs relating to additions to MedSolutions’ transportation fleet as its markets and customer base expand. As a result of the PIWS acquisition on November 30, 2005, MedSolutions entered new markets located in West Texas, Kansas and Missouri and incurred costs associated with added personnel, facilities, transportation, and treatment costs in each of those markets. Other costs associated with the increase are attributable to repair and maintenance costs of operating MedSolutions’ mobile treatment units acquired in the PIWS acquisition.
     Selling, general and administrative expenses. MedSolutions’ selling, general and administrative expenses increased $1,380,029, or 56.3%, to $3,829,489 during 2006, from $2,449,460 in 2005. The increase was caused by costs associated with an increased sales force including MedSolutions’ new markets in West Texas, Kansas and Missouri in 2006 as compared to 2005, increases in director compensation, increased administrative personnel and a non-cash charge of $240,000 related to stock compensation granted to executive employees in 2005. Other increases are associated with higher travel costs from MedSolutions’ executive staff seeking acquisition and market opportunities to expand MedSolutions’ business and market share and administrative costs associated with the SteriLogic acquisition.
     Depreciation and amortization. Depreciation and amortization increased by $622,061 or 82.8%, to $1,373,318 during 2006 from $751,257 during 2005. The primary cause for the increase was from depreciation expense resulting from the purchases of fixed assets from the PIWS acquisition and increases in amortization expense from higher carrying values of customer lists purchased from the three acquisitions in 2005 and SteriLogic in 2006.
     Interest expense. MedSolutions’ interest expense increased $108,225 or 28.9%, to $482,485 in 2006 from $374,260 during 2005. Interest expense increased primarily due to the capitalization and amortization of certain debt conversion costs related to the Investment Agreement that was modified during the three months ended June 30, 2006 (see Note 7) and the addition of $500,000 of new debt under the Investment Agreement closed in March 2006. In connection with such transactions related to the debt conversion costs, MedSolutions paid financing fees that were deferred and are being amortized on a straight line method over the remaining life of the convertible debt. The outstanding principal amount of the convertible debt issued by MedSolutions pursuant to the Investment Agreement was subsequently converted by the Investor into shares of MedSolutions common stock on March 30, 2007. Interest expense for the year ended December 31, 2006 was reduced from the conversion of approximately $1.2 million in shareholder loans and advances into MedSolutions’ equity on June 30, 2005.
     Gain on ATE settlement. During the year ended December 31, 2005, MedSolutions recorded a one time gain of $650,468 resulting from a settlement and extinguishment of debt with AmeriTech Environmental, Inc. on February 11, 2005.
     Other Income. Other income of $40,135 was recorded in 2006 due to the extinguishment of convertible debentures discussed in Note 10 to MedSolutions’ consolidated financial statements for the fiscal year ended December 31, 2006 included within “MedSolutions’ Historical Consolidated Financial Statements and Supplementary Data” and the notes to such financial statements included in this proxy statement/prospectus.

101


Table of Contents

     Net income (loss). MedSolutions’ net loss was ($771,111) in 2006 compared to net income of $810,670 in 2005. The net loss in 2006 was due to the factors described above.
Three Months Ended June 30, 2007 Compared to Three Months Ended June 30, 2006
     Revenues. MedSolutions’ revenues increased $811,192, or 26.6% to $3,863,897 during the three months ended June 30, 2007 from $3,052,705 during the three months ended June 30, 2006. The increase in revenue was attributable, in part, to the SteriLogic acquisition completed in August 2006 that increased revenue by approximately $435,000 during the there months ended June 30, 2007 plus additions in revenue of approximately $340,000 in new business from Sharps and EnviroSafe customers and new customers in the Missouri market.
     Cost of Revenues. MedSolutions’ cost of revenues increased $630,655 or 36.1% to $2,379,916 during the three months ended June 30, 2007 from $1,749,261 during the three months ended June 30, 2006. Gross margin for MedSolutions decreased to 38.4% for the three months ended June 30, 2007 from 42.7% for the three months ended June 30, 2006. The increase in cost of revenues was caused by new cost of revenues associated with the SteriLogic acquisition, increases in transportation costs primarily in Kansas and Missouri as MedSolutions expands in those markets, and higher processing costs as MedSolutions uses third party vendors to process its customer waste from South Texas.
     Selling, general and administrative expenses. MedSolutions’ selling, general and administrative expenses decreased $52, to $826,011 during the three months ended June 30, 2007 from $826,063 during the three months ended June 30, 2006. While SteriLogic added approximately $74,000 in new S, G & A expense for 2007, the increase was offset by decreases in sales and marketing expenses due to a reduction in MedSolutions’ sales staff and decreases in costs associated with promotional and advertising expenses.
     Depreciation and Amortization. Depreciation and amortization increased by $45,911 or 14.2% to $368,589 during the three months ended June 30, 2007 from $322,678 during the three months ended June 30, 2006. The primary cause for the increase was from higher depreciation expense resulting from the purchases of fixed assets in 2006 and 2007 related to new equipment purchased to expand and service new Sharps business and assets purchased related to the SteriLogic acquisition.
     Interest expense. MedSolutions’ interest expense increased $21,609 or 15.9% to $157,717 during the three months ended June 30, 2007 from $136,108 during the three months ended June 30, 2006. Interest expense increased in 2007 due to a new working capital loan from Park Cities Bank, additional debt issued by MedSolutions to shareholders for working capital and new equipment financing, and new debt issued to the sellers of SteriLogic for part of the acquisition purchase price.
     Net income. Net income increased $113,069 or 608.1% to $131,664 during the three months ended June 30, 2007 from $18,595 during the three months ended June 30, 2006. MedSolutions’ net income increased in 2007 due to the factors described above.
Six Months Ended June 30, 2007 Compared to Six Months Ended June 30, 2006
     Revenues. MedSolutions’ revenues increased $1,384,768, or 22.2% to $7,626,227 during the six months ended June 30, 2007 from $6,241,459 during the six months ended June 30, 2006. The increase in revenue is attributable in part, to the SteriLogic acquisition completed in August 2006 that increased revenue by approximately $795,000 during the six months ended June 30, 2007 plus additions in revenue of approximately $646,000 in new business from Sharps and EnviroSafe customers and new customers in the Missouri market.
     Cost of Revenues. MedSolutions’ cost of revenues increased $1,066,504 or 30.4% to $4,575,324 during the six months ended June 30, 2007 from $3,508,820 during the six months ended June 30, 2006. Gross margin for MedSolutions decreased to 40.0% for the six months ended June 30, 2007 from 43.8% for the six months ended June 30, 2006. The increase in cost of revenues was caused by new cost of revenues associated with the SteriLogic acquisition, increases in transportation costs primarily in Kansas and Missouri as MedSolutions expands in those markets, and higher processing costs as MedSolutions uses third party vendors to process its customer waste from South Texas and Louisiana.
     Selling, general and administrative expenses. MedSolutions’ selling, general and administrative expenses increased $54,812 or 3.3%, to $1,696,049 during the six months ended June 30, 2007 from $1,641,237 during the six months ended June 30, 2006. While SteriLogic added approximately $167,000 in new S, G & A expense for 2007, the increase was offset by decreases in sales and marketing expenses due to a reduction in MedSolutions’ sales staff and decreases in costs associated with promotional and advertising expenses.
     Depreciation and Amortization. Depreciation and amortization increased by $104,737 or 16.6% to $733,858 during the six months ended June 30, 2007 from $629,121 during the six months ended June 30, 2006. The primary cause for the increase was from higher depreciation expense resulting from the purchases of fixed assets in 2006 and 2007 related to new equipment purchased to expand and service new Sharps business and assets purchased related to the SteriLogic acquisition.
     Interest expense. MedSolutions’ interest expense increased $196,465 or 84.2% to $429,751 during the six months ended June 30, 2007 from $233,286 during the six months ended June 30, 2006. Interest expense increased significantly due to the immediate expense of deferred financing fees related to the Investor notes that were converted into MedSolutions common stock on March 31, 2007. The excess amount of deferred financing fees charged to interest expense during the current period was approximately $104,000. Other increases to interest expense were due to additional debt issued by MedSolutions to shareholders for working capital and new equipment financing plus new debt issued to the sellers of SteriLogic for part of the acquisition purchase price.
     Net income. Net income decreased $37,750 or 16.5% to $191,245 during the six months ended June 30, 2007 from $228,995 during the six months ended June 30, 2006. MedSolutions’ net income decreased in 2007 due to the factors described above.

102


Table of Contents

Liquidity and Capital Resources
     Source of Funds for Operations and Capital Expenditures.
     MedSolutions’ principal source of liquidity is collections on accounts receivable from waste management service revenue, from sales of its common stock and Series A Preferred Stock through private offerings to certain individuals, primarily existing shareholders, and from loans and advances received from certain shareholders. Revenues during 2006 were approximately $280,000 per month higher than in 2005, stemming primarily from the acquisitions in 2005 and 2006 discussed previously. The principal uses of liquidity are payments for labor, fuel, material and expenses, and debt and lease obligations to carry out MedSolutions’ regulated medical waste management services.
     Historically, MedSolutions has met its cash requirements based on a combination of revenues from operations, shareholder loans and advances, and proceeds from the sale of debt and equity securities. Based on the projected operations for 2007, MedSolutions’ management believes cash to be generated from operations and funds raised from other alternative sources if needed, will be sufficient to satisfy MedSolutions’ historical and current cash obligations.
     Discussion of Liquidity — Year 2006 Compared to 2005
     At December 31, 2006, MedSolutions’ working capital deficit was $(1,899,921), compared to a working capital deficit of $(2,397,992) at December 31, 2005.
     Net cash provided (used) in operating activities for the year ended December 31, 2006 was $597,729 during 2006, compared to $(311,414) for 2005. This increase was caused primarily from an increase in accounts payable and accrued liabilities resulting from the accrual of director fees not paid at December 31, 2006; the accrual of year-end payroll costs and taxes paid in January 2007; and the assumption of liabilities from the SteriLogic acquisition.
     Net cash used in investing activities for the year ended December 31, 2006 was $(621,043) compared to ($1,340,713) for the year ended December 31, 2005. The lesser amount in 2006 was caused by the decrease in the cash portion used for an acquisition in 2006 of $24,283 compared to $1,115,000 used in 2005. Also, MedSolutions invested $596,760 in fixed asset additions in 2006 compared to $225,713 in 2005.
     Net cash provided by financing activities was $23,314 during the year ended December 31, 2006, compared to $1,652,127 for the year ended December 31, 2005. Cash proceeds from the sale of MedSolutions common stock and Series A Preferred Stock were $809,000 compared to $1,338,968 in 2005. Proceeds from shareholder loans were $1,150,000 in 2006 compared to $1,375,000 in 2005. Offsetting the proceeds from the sale of MedSolutions stock and new shareholder loans were payments to shareholders and others on existing debt totaling $1,787,054 in 2006 compared to $974,148 in 2005.
June 30, 2007 Compared to December 31, 2006
     At June 30, 2007, MedSolutions’ working capital deficit was $1,527,059 compared to a working capital deficit of $1,899,921 at December 31, 2006, a favorable increase of $372,862 for the six month period ended June 30, 2007. The increase in working capital was caused from increased accounts receivable resulting from higher revenue during the six month period ended June 30, 2007 versus 2006 and from the conversion of the Investor debt into MedSolutions common stock.
     MedSolutions had net income of $197,245 for the six months ended June 30, 2007 and has a working capital deficiency of $1,527,059 at June 30, 2007. MedSolutions also used $266,626 of cash in its operating activities during the six months ended June 30, 2007.
     During the six months ended June 30, 2007, MedSolutions received approximately $1.4 million of proceeds under a working capital credit facility obtained in March 2007 and an additional $175,000 of additional loans from its shareholders obtained in January 2007. MedSolutions used the proceeds it received in these financing transactions to repay certain indebtedness, purchase property and equipment and fund its operating activities. Subsequent to June 30, 2007, the maturity dates of approximately $270,000 of obligations due to certain related parties were extended to December 31, 2007.
     MedSolutions has historically financed its operations by obtaining loans from its shareholders and other external sources. Although MedSolutions believes that the merger with Stericycle is likely to be completed during the quarter ending December 31, 2007, there can be no assurance that the shareholders of MedSolutions will in fact approve the merger or that other conditions that must be satisfied in order to close the merger will actually be met. In the event that the merger is not completed, MedSolutions will be required to obtain additional capital and/or continue its positive earnings trend in order to fund its operations on a stand alone basis. There can be no assurance MedSolutions will be successful in its efforts to raise additional capital and/or continue its positive earnings trend, if necessary, to fund its operations on a stand alone basis. These circumstances could have a material adverse effect on MedSolutions’ ability to sustain its operations in future periods.

103


Table of Contents

June 30, 2007 Compared to June 30, 2006
     Net cash used in operating activities was $266,626 during the six months ended June 30, 2007 as compared to net cash provided of $232,785 during the six months ended June 30, 2006. The decrease in cash provided in operating activities was due to increases in MedSolutions’ net accounts receivable and reducing its accounts payable and accrued liabilities during the period.
     Net cash used in investing activities during the six months ended June 30, 2007, was $270,291 attributable to additions to property and equipment compared to $354,826 during the six months ended June 30, 2006.
     Net cash provided by financing activities was $536,917 during the six months ended June 30, 2007 compared to $233,675 during the six months ended June 30, 2006. Proceeds from advances from the working capital loan totaled $1,439,558 and a new shareholder loan of $175,000 contributed to the cash provided by financing activities during the current period but were offset by payments on existing debt to shareholders and other bank financing of $1,041,124 for the six months ended June 30, 2007. During the six months ended June 30, 2006, MedSolutions raised $709,000 through the sale of its common stock and issued $600,000 in new debt to shareholders, which was offset by $950,938 in payments to shareholders and third parties on existing debt.
     Net cash did not change during the six months ended June 30, 2007 based upon the factors discussed above.
     Other Liquidity Matters
     At June 30, 2007, MedSolutions’ long-term obligations were $4,211,331, including bank debt and equipment financing of $2,275,695 and notes payable to shareholders and seller promissory notes from acquisitions totaling $1,945,636.

104


Table of Contents

     Tate Investments, LLC
     On July 15, 2005, MedSolutions entered into the definitive Investment Agreement with the Investor. Pursuant to the terms of the Investment Agreement, the Investor committed to lend up to $1,000,000 to MedSolutions according to the terms of a 10% Senior Secured Promissory Note (the “Note”) dated as of July 15, 2005. The Note was secured by MedSolutions’ and its subsidiaries’ accounts receivable and by a second-lien deed of trust mortgage on MedSolutions’ Garland facility pursuant to the terms of a General Business Security Agreement and a Deed of Trust, respectively, each dated as of July 15, 2005. All outstanding amounts under the Note bore interest at the rate of 10% per year, unless MedSolutions was in default pursuant to the terms of the Investment Agreement, in which event all outstanding amounts under the Note bore interest at a rate equal to the prime rate as published in the Wall Street Journal from time to time plus 8%. The outstanding principal amount of the Note and any accrued but unpaid interest thereon were convertible at the option of the Investor into shares of MedSolutions common stock at the initial conversion price of $0.65 per share, as subject to certain adjustments from time to time. MedSolutions was permitted to prepay any or all of the outstanding principal amount of the Note and any accrued but unpaid interest thereon on or after January 15, 2007 without the prior consent of the Investor and without any prepayment premium or penalty; provided, however, that MedSolutions first provided the Investor with 30 days’ prior written notice of its intent to prepay any or all of such outstanding principal amount accompanied by either an irrevocable written financing commitment or other evidence of MedSolutions’ ability to make the proposed prepayment. The Investor was permitted to, after receipt of such a prepayment notice, elect to convert any or all of such outstanding principal amount proposed to be prepaid into shares of MedSolutions common stock as discussed above. Also pursuant to the terms of the Investment Agreement, the Investor committed to purchase, and MedSolutions committed to sell, up to $1,000,000 of MedSolutions’ common stock to the Investor at the initial purchase price of $0.65 per share (as subject to certain adjustments from time to time) pursuant to the terms of a Subscription Agreement (the “Subscription Agreement”) dated as of July 15, 2005. The entire outstanding principal amount of the Note was converted into MedSolutions common stock on March 30, 2007.
     Pursuant to the terms of the Investment Agreement, MedSolutions, the Investor and certain shareholders of MedSolutions entered into an Investor’s Rights Agreement (the “Rights Agreement”) pursuant to which MedSolutions has granted certain demand registration rights to the Investor with respect to any shares of MedSolutions common stock obtained pursuant to the Note or the Subscription Agreement. The Rights Agreement grants the Investor one demand registration exercisable after December 31, 2006, and in the event such demand registration is exercised MedSolutions must use its best efforts to register the Investor’s shares of MedSolutions common stock until either the shares are either registered or sold pursuant to SEC Rule 144 or another applicable registration exemption. The Rights Agreement contains no penalty provisions or settlement alternatives that would result in the issuance of additional shares of MedSolutions common stock or a cash payment to the Investor in the event that MedSolutions is unable to register the Investor’s shares. The Rights Agreement also provides unlimited piggyback registration rights to the Investor. The Rights Agreement also grants the Investor the right to designate one nominee for election to MedSolutions’ Board of Directors, or two nominees in the event that Mr. Joseph Tate, the beneficial owner of the Investor, is designated as a nominee by the Investor. On September 15, 2005, MedSolutions’ Board of Directors selected David Mack to fill a vacancy on the Board of Directors based upon the nomination by Mr. Tate. Pursuant to the terms of the Rights Agreement, MedSolutions may not, prior to the registration of the MedSolutions common stock owned by the Investor with the SEC, increase the size of its Board of Directors to more than five members unless the Investor also designates Mr. Joseph Tate as a nominee, in which event the Board of

105


Table of Contents

Directors may have no more than seven members. Certain MedSolutions shareholders who are party to the Rights Agreement have also granted certain rights of co-sale to the Investor and agreed to vote their shares of MedSolutions common stock in favor of the election of the Investor’s nominee(s). The Investor’s right to designate nominees to MedSolutions’ Board of Directors continues until such time as: (i) the Investor effectuates, in one or a series of transactions, a transfer of shares of MedSolutions common stock whereby the number of shares of such common stock owned by the Investor after such transfer is less than 75% of the number of shares of common stock owned by the Investor before the transfer, at which such time the Investor’s right to designate nominees to MedSolutions’ Board of Directors will be reduced to the right to designate one nominee to MedSolutions’ Board of Directors; (ii) the Investor effectuates, in one or a series of transactions, a transfer of shares of MedSolutions common stock whereby the number of shares of such common stock owned by the Investor after the transfer is less than 50% of the number of shares of common stock owned by the Investor prior to the transfer, at which such time the Investor’s right to designate nominees to MedSolutions’ Board of Directors will terminate; or (iii) the MedSolutions common stock owned by the Investor has been registered with the SEC.
     On March 15, 2006, MedSolutions issued another convertible promissory note in the amount of $500,000 to the Investor. The promissory note was payable in 35 monthly installments of interest only with all principal and interest due on March 31, 2009. The note accrued interest at 10% for the first 12 months, 11% for months 13 through 24 and 12% for months 25 through maturity. The effect of the increasing interest rate under EITF 86-15 “Increasing-Rate Debt” was determined to be de minimus. MedSolutions was permitted to prepay a portion or all of the amount outstanding under the terms of the note after March 31, 2007, provided that MedSolutions first notified the Investor of its intent to prepay, after which the Investor was permitted 30 days to convert the note into shares of MedSolutions common stock. The Investor had the right to convert the amount outstanding plus accrued but unpaid interest at the time of conversion. The conversion price for the $500,000 note agreed to was $0.85 per share during the period beginning March 15, 2006 through March 31, 2007, $1.00 per share during the period beginning April 1, 2007 through March 31, 2008, and $1.15 per share during the period April 1, 2008 through maturity. The promissory note was secured by two PIWS mobile units and was cross-collateralized by the Investor’s liens on MedSolutions’ accounts receivable and its Garland facility pursuant to the Investment Agreement. The proceeds from the promissory note were used by MedSolutions to purchase equipment. The entire outstanding principal amount of the promissory note was converted into MedSolutions common stock on March 30, 2007.
     On May 22, 2006, MedSolutions and the Investor agreed to amend the Investment Agreement to lower the conversion price for the $1,000,000 Note to $0.55 per share from $0.65 per share in exchange for the Investor retroactively (as of July 15, 2005, the date the Investment Agreement was executed) eliminating the requirements for MedSolutions to achieve certain earnings targets thereunder. In connection with the conversion price adjustment, MedSolutions was required to record a beneficial conversion charge of $153,846. The beneficial conversion charge represents the incremental fair value of the impact from lowering the conversion rate and was to be amortized over the remaining life of the note. As of December 31, 2006, the remaining amount of the beneficial conversion charge to amortize was $102,564.
     As of December 31, 2006, the total principal amount owed by MedSolutions to the Investor was $1,397,436 (net of discount of $102,564), all of which was subsequently converted by the Investor into shares of MedSolutions common stock on March 30, 2007.
     MedSolutions is obligated under various installment notes payable for the purchase of equipment with an aggregate cost of $864,261. The notes, which bear interest at rates ranging from 8.0% to 16.1%, are due at various dates through 2011 and are payable in monthly installments totaling approximately $30,549 consisting of principal and interest. The equipment acquired collateralizes the notes.

106


Table of Contents

     Extinguishment of Convertible Debentures
     MedSolutions issued an aggregate of $1,100,000 of 15% Convertible Redeemable Subordinated Debentures (the “Series I Debentures”) in 1994 and 1995 with a final maturity date of March 31, 1999, and containing a provision for conversion of the Series I Debentures, at the option of the holders thereof, into shares of MedSolutions common stock. MedSolutions also issued an aggregate of $256,125 of 10% Convertible Redeemable Debentures (“Series II Debentures,” and together with the Series I Debentures, the “Debentures”) in 1998 with a maturity date of November 1, 1999, and containing a provision for conversion of the Series II Debentures, at the option of the holders thereof, into shares of MedSolutions common stock.
     Due to cash constraints, MedSolutions was not able to redeem the Debentures in 1999 pursuant to their respective terms. MedSolutions offered (the “Conversion Offering”) the holders of the Debentures the opportunity to convert their Series I Debentures and Series II Debentures into shares of MedSolutions common stock at a conversion rate of $1.50 and $1.75, respectively.
     Certain holders of Debentures did not respond to the Conversion Offering in 1999, and the offer to convert the Debentures into MedSolutions common stock has since expired and any contractual claims for rights pursuant to the Debentures have been time-barred by the applicable statute of limitations. Accordingly, MedSolutions extinguished the Debentures on November 15, 2006 and any obligation owed under their terms. MedSolutions recorded other income of $40,135 and reversed all accrued interest as a result of extinguishment.
     On January 1, 2007, MedSolutions issued promissory notes to its directors for payment of their 2006 board compensation. Additional promissory notes were issued to the Chairman of the Board and the President/Chief Executive Officer of MedSolutions for payment of compensation for giving their personal guaranties related to certain indebtedness by MedSolutions to various third parties. The total amount of the promissory notes issued is $292,005 and the notes accrue interest at 12% with final payment of all principal and accrued interest due on July 1, 2007.
     On January 2, 2007, MedSolutions issued a promissory note to the Investor, which loaned $175,000 to MedSolutions for equipment expansion purposes. The promissory note bears interest at 12% and is payable in 24 equal monthly installments of principal and interest in the amount of $5,813 each, with the balance of the principal and any accrued and unpaid interest due upon maturity of the note on December 28, 2008.
     On January 31, 2007, MedSolutions renewed and extended for six months a $175,000 promissory note to On Call. The note accrues interest at 12% and is payable in monthly installments of interest only with the principal and any accrued and unpaid interest due upon maturity of the note on July 31, 2007. As consideration for this extension, MedSolutions agreed to enter into an agreement with Medical Waste of North Texas, LLC (“MWNT” an entity owned by the former owner of On Call) for MedSolutions to treat and dispose of regulated medical waste that is brought to MedSolutions’ Garland facility by MWNT, effective September 1, 2007. The initial term of this agreement is for 24 months, and the agreement automatically renews for additional one-year extensions unless either party notifies the other party in writing at least 30 days but not more than 90 days prior to any such renewal date of its desire not to renew the agreement.
     On March 27, 2007, EMSI entered into a $1,500,000 secured, one-year loan and security agreement with Park Cities Bank, Dallas, Texas. The terms of the loan and security agreement provide EMSI with a $1,500,000 revolving line of credit, subject to certain downward adjustments from time to time based upon the value of the collateral securing the line of credit. The performance by EMSI of its obligations

107


Table of Contents

under the loan and security agreement is secured by all of EMSI’s personal property, including without limitation its account receivables, and a first-lien mortgage deed of trust on EMSI’s Garland facility, and is unconditionally guaranteed by MedSolutions’ President/Chief Executive Officer and its Chairman of the Board. The proceeds of the borrowings under the loan and security agreement may only be used for general corporate purposes, including without limitation providing working capital to EMSI for the purposes of financing its operations, production and marketing and sales efforts, costs related to the expansion of EMSI’s business operations, and the acquisition of the assets of businesses engaged in businesses the same as, similar to, or complementary to EMSI’s business operations. Borrowings under the loan and security agreement bear interest at the lesser of (1) a fluctuating rate of interest equal to 1.0% in excess of the prime rate as designated in the Money Rates Section of the Wall Street Journal from time to time or (2) the maximum rate permissible by applicable law. Accrued and unpaid interest under the loan and security agreement is payable on the first day of each month commencing on April 1, 2007. In addition, EMSI paid an origination fee to the Park cities Bank in the amount of $15,000. The loan and security agreement contains, among other provisions, conditions precedent, covenants, representations and warranties and events of default customary for facilities of this size, type and purpose. Negative covenants with respect to EMSI include certain restrictions or limitations on, among other provisions, the incurrence of indebtedness; liens; investments, loans and advances; restricted payments, including dividends; consolidations and mergers; sales of assets (subject to customary exceptions for sales of inventory in the ordinary course and sales of equipment in connection with the replacement thereof in the ordinary course); and changes of ownership or control. Affirmative covenants with respect to EMSI include covenants regarding, among other provisions, financial reporting. The loan and security agreement will mature and expire on April 1, 2008, at which time all outstanding amounts under such agreement will be due and payable. The outstanding amounts under the loan and security agreement may be prepaid by EMSI at any time without penalty, and any principal amounts borrowed and repaid thereunder may be reborrowed by EMSI prior to the maturity date so long as the aggregate principal amount outstanding at any time does not exceed the $1,500,000 maximum loan commitment (as subject to downward adjustment based on the value of the collateral as described above). Under certain conditions the loan commitment under the loan and security agreement may be terminated by Park Cities Bank and amounts outstanding under such agreement may be accelerated. Bankruptcy and insolvency events with respect to EMSI or either of the guarantors will result in an automatic termination of lending commitments and acceleration of the indebtedness under such agreement. Subject to notice and cure periods in certain cases, other events of default under the loan and security agreement will result in termination of lending commitments and acceleration of indebtedness under such agreement at the option of Park Cities Bank. Such other events of default include failure to pay any principal and/or interest when due, failure to comply with covenants, breach of representations or warranties in any respect, non-payment or acceleration of other material debt of EMSI or the guarantors, the death of either guarantor of the termination of either of their guaranties, certain judgments against EMSI or a guarantor, a material adverse change in the business or financial condition of EMSI or either guarantor, or if Park Cities Bank in good faith deems itself insecure. In connection with providing his personal guarantee and previous guarantees, MedSolutions paid its Chairman of the Board $15,506 in the form of a promissory note which accrues interest at 12% and matures on July 1, 2007 when all principal and accrued interest is due and payable. Also, MedSolutions accrued $17,506 for the benefit of its President/Chief Executive Officer in payment for his personal guarantee for this loan and other company indebtedness.
     On March 1, 2007, MedSolutions provided written notice to the Investor that MedSolutions intended to prepay in full on April 2, 2007 all outstanding principal and interest owed by MedSolutions to the Investor pursuant to the $1,000,000 Note and the $500,000 note issued by MedSolutions to the Investor, each as described above. MedSolutions intended to use the proceeds of the loan from Park Cities Bank described above to prepay the such notes.

108


Table of Contents

     On March 31, 2007, 96,667 shares of MedSolutions Series A Preferred Stock were converted into 96,667 shares of the MedSolutions common stock in accordance with the certificate of designation for the Series A Preferred Stock. The terms of the certificate of designation required the holders of the Series A Preferred Stock to convert their shares into MedSolutions common stock on a share for share basis on the second anniversary from the date of issuance of the Series A Preferred Stock. All dividends declared with regard to the issuance of the Series A Preferred Stock have been paid. As of March 31, 2007, there were no shares of Series A Preferred Stock outstanding.
Doubtful Accounts Allowance
     At June 30, 2007, MedSolutions had gross receivables from trade accounts of $2,576,723 with an allowance for bad debt of $119,300. At March 31, 2007, MedSolutions had gross receivables from trade accounts of $2,226,682 with an allowance for bad debt of $112,295. At December 31, 2006, gross receivables were $2,022,530 with an allowance for bad debt of $174,989.
     MedSolutions accrued $112,000 of bad debt expense in 2006 to increase its allowance for bad debt related to one specific customer receivable that was deemed uncollectible in the first quarter of 2007. The receivable was approximately $75,000 that was charged to the allowance resulting in the decrease in the allowance account from December 31, 2006 to March 31, 2007 and June 30, 2007.
     MedSolutions performs a bad debt allowance analysis on a quarterly basis based upon its current accounts receivable aging and makes a determination if the allowance for bad debt is adequate for possible future losses. In such analysis, MedSolutions assigns a percentage that is estimated to be lost for each aging bucket within its receivables. After the amounts reflected by such percentages are aggregated and compared to the general ledger balance of MedSolutions’ bad debt allowance, MedSolutions determines if additional reserves are needed to replenish a deficit.
     At March 31, 2007 and June 30, 2007, based upon MedSolutions’ analysis of its bad debt allowance, MedSolutions believes that its allowance is adequate for future bad debt losses.
Material Commitments for Capital Expenditures
     MedSolutions currently has no significant commitments for capital expenditures.
Off-Balance Sheet Arrangements
     During the year ended December 31, 2006, MedSolutions had off balance sheet arrangements related to its lease obligations. MedSolutions is obligated under such lease arrangements for $1,095,753 through 2012. The amount obligated under the lease arrangements is one operating lease totaling $548,229 payable through 2010 to a leasing firm that specializes in heavy transportation equipment financing and has financed the majority of MedSolutions’ transportation equipment. A second obligation is an operating lease with a remaining balance of $547,524 as of December 31, 2006 and is payable through 2012 to MedSolutions’ landlord for its corporate headquarters. Both leases are routine and typical in nature and yet critical to MedSolutions’ operations in that they provide financing that is necessary for us to provide services to its customers and house the corporate functions and operations of MedSolutions. The operating leases are beneficial from a financial perspective in that they do not add to the liabilities of MedSolutions as shown on its balance sheet; however, the costs of such leases are included in MedSolutions’ statement of operations and statement of cash flows for each period reported.
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
     MedSolutions had no changes in or disagreements with accountants on accounting and financial disclosure during the fiscal years ended December 31, 2005 and 2006.

109


Table of Contents

Security Ownership of Certain MedSolutions Beneficial Owners and Management
     The following table sets forth each certain information concerning the number of shares of MedSolutions common stock owned beneficially as of October 8, 2007, the record date for the special meeting, by: (i) persons known to us to own more than five percent of any class of MedSolutions’ voting securities; (ii) each of MedSolutions’ directors and the executive officers; and (iii) all MedSolutions directors and executive officers as a group. Unless otherwise indicated, the shareholders listed possess sole voting and investment power with respect to the shares shown.
                 
    Number of Shares    
Name and Address of Beneficial Owner   Beneficially Owned(1)   Percent of Class(2)
Matthew H. Fleeger, President, CEO and Director
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    1,170,416 (3)     4.4 %
Winship B. Moody, Sr., Chairman of the Board of Directors
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    836,485       3.2 %
Ajit S. Brar, Director
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    909,875 (4)     3.4 %
David L. Mack, Director
12750 Merit Drive – Park Central VII, Suite 770 Dallas, Texas 75251
    62,222 (5)     0.2 %
Steven R. Block, Director
12750 Merit Drive – Park Central VII, Suite 770 Dallas, Texas 75251
    50,000       0.2 %
Lonnie P. Cole, Sr., Senior Vice President, Sales
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    149,000 (6)     0.6 %
Steve Evans, Vice President, Finance
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    145,665 (7)     0.5 %
Alan Larosee, Vice President, Operations
12750 Merit Drive –Park Central VII, Suite 770 Dallas, Texas 75251
    221,666 (8)     0.8 %
James M. Treat, Vice President, Business Development
12750 Merit Drive – Park Central VII, Suite 770 Dallas, Texas 75251
    173,333 (9)     0.6 %
All Directors and Executive Officers as a Group (9 persons)
    3,718,662       13.6 %(10)
 
               
Tate Investments, LLC
12750 Merit Drive – Park Central VII, Suite 770 Dallas, Texas 75251
    3,944,880       14.9 %
 
               
Mark Altenau, M.D.
12750 Merit Drive – Park Central VII, Suite 770 Dallas, Texas 75251
    2,153,292 (11)     8.1 %
 
(1)   Pursuant to Rule 13d-3 under the Exchange Act, a person has beneficial ownership of any securities as to which such person, directly or indirectly, through any contract, arrangement, undertaking, relationship

110


Table of Contents

    or otherwise, has or shares voting power and/or investment power as to which such person has the right to acquire such voting and/or investment power within 60 days. Percentage of beneficial ownership as to any person as of a particular date is calculated by dividing the number of shares beneficially owned by such person by the sum of the number of shares outstanding as of such date and the number of unissued shares as to which such person has the right to acquire voting and/or investment control within 60 days. The number of shares shown includes outstanding shares owned as of October 8, 2007, by the person indicated and shares underlying warrants, options and/or convertible debt and accrued interest thereon owned by such person on October 8, 2007, that were exercisable within 60 days of that date.
 
(2)   Applicable percentage ownership is based on 26,458,446 shares of MedSolutions common stock outstanding on October 8, 2007, and on shares issuable to such holder within 60 days of October 8, 2007.
 
(3)   Includes 670,790 shares owned by Preston Harris Interests, Inc., a Texas corporation, of which Mr. Fleeger is the president.
 
(4)   Includes 100,000 shares of MedSolutions common stock underlying convertible debt and accrued interest thereon and options for 93,208 shares of common stock.
 
(5)   Includes options for 62,222 shares of MedSolutions common stock.
 
(6)   Includes 149,000 shares owned by Med-Con Waste Solutions, Inc., a Texas corporation, of which Mr. Cole was the President and Chief Executive Officer.
 
(7)   Includes options for 145,665 shares of MedSolutions common stock.
 
(8)   Includes options for 221,666 shares of MedSolutions common stock.
 
(9)   Includes options for 173,333 shares of MedSolutions common stock.
 
(10)   Applicable percentage ownership is based on 26,458,446 shares of MedSolutions common stock issued and outstanding on October 8, 2007, and on shares issuable to such holders within 60 days of October 8, 2007.
 
(11)   Includes options for 69,833 shares of MedSolutions common stock, and 725,826 shares of MedSolutions common stock held in his individual retirement account.

111


Table of Contents

MEDSOLUTIONS’ HISTORICAL CONSOLIDATED FINANCIAL STATEMENTS AND
SUPPLEMENTARY DATA
         
    Page
2005-2006 Audited Financial Statements
       
    113  
    114  
    115  
    116  
    118  
    120  
 
       
2004-2005 Audited Financial Statements
       
    153  
    154  
    155  
    156  
    158  
    160  
 
       
Unaudited Interim Financial Statements
       
    197  
    198  
    199  
    200  
    202  

112


Table of Contents

To the Board of Directors
MedSolutions, Inc.
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
We have audited the accompanying consolidated balance sheets of MedSolutions, Inc. (the “Company”) as of December 31, 2006 and 2005, and the related consolidated statements of operations, stockholders’ equity and cash flows for the years then ended. These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements based on our audits.
We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. Our audit included consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the consolidated financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall consolidated financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the consolidated financial position of MedSolutions, Inc. as of December 31, 2006 and 2005, and the results of its operations and cash flows for the years then ended, in conformity with accounting principles generally accepted in the United States of America.
MARCUM & KLIEGMAN, LLP
New York, New York
March 10, 2007

113


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED BALANCE SHEETS
                 
    December 31,  
    2006     2005  
ASSETS
Current Assets:
               
Cash
  $     $  
Accounts receivable — trade, net of allowance of $174,989 and $69,240
    1,847,541       1,405,603  
Prepaid expenses and other current assets
    366,141       258,523  
Supplies
    26,109       14,106  
 
           
Total Current Assets
    2,239,791       1,678,232  
Property and equipment — at cost, net of accumulated depreciation of $2,805,851 and $1,836,756
    3,586,766       3,150,504  
Intangible assets – Customer list, net of accumulated amortization of $1,028,993 and $624,770
    1,408,189       1,437,912  
Intangible assets — Goodwill
    3,403,025       2,597,021  
Intangible assets — permits
    152,749       65,007  
Other assets
    46,943       102,126  
 
           
Total Assets
  $ 10,837,463     $ 9,030,802  
 
           
 
               
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current Liabilities:
               
Convertible debentures
  $     $ 40,135  
Current maturities of long-term obligations
    372,552       145,628  
Accounts payable
    1,507,220       1,130,155  
Accrued liabilities
    1,281,443       962,327  
Current maturities – notes payable to Tate Investments, LLC
          250,000  
Current maturities – notes payable to Med-Con
    127,703       157,861  
Current maturities – notes payable to On Call
    294,541       495,819  
Current maturities – notes payable to Positive Impact
    97,705       360,669  
Current maturities – notes payable to Abele-Kerr Investments, LLC
    38,948        
Current maturities – notes payable stockholders
    419,600       487,891  
Current maturities – litigation settlements
          26,735  
Advances from stockholders
          19,004  
 
           
Total Current Liabilities
    4,139,712       4,076,224  
 
Long-term obligations, less current maturities
    1,003,174       806,952  
Notes payable – Tate Investments, LLC, less current maturities, net of discount of $102,564 and $0
    1,397,436       725,000  
Notes payable – Med-Con, less current maturities
    147,047       274,749  
Notes payable – On Call, less current maturities
          119,541  
Notes payable – Positive Impact, less current maturities
    333,796       489,331  
Notes payable – Abele-Kerr Investments, LLC, less current maturities
    211,052        
Notes payable – stockholders, less current maturities
    294,267       359,131  
 
           
Total Liabilities
    7,526,484       6,850,928  
 
           
 
               
Commitments and Contingencies
               
 
               
Stockholders’ Equity:
               
Preferred stock (par value $.001) – 100,000,000 shares authorized at December 31, 2006 and December 31,2005,respectively, 96,667 shares issued and outstanding at December 31,2006 and 283,172 shares issued at December 31, 2005 (liquidation preference $145,001 – 2006; $424,758 – 2005)
    97       283  
Common stock (par value $.001) - 100,000,000 shares authorized at December 31, 2006 and December 31,2005; 23,792,985 shares issued and 23,780,785 outstanding at December 31, 2006 and 22,228,980 shares issued and 22,216,780 outstanding at December 31, 2005
    23,793       22,229  
Additional paid-in capital
    26,558,608       24,657,770  
Accumulated deficit
    (23,253,519 )     (22,482,408 )
Treasury stock, at cost - 12,200 shares at December 31, 2006 and December 31, 2005
    (18,000 )     (18,000 )
 
           
Total Stockholders’ Equity
    3,310,979       2,179,874  
 
           
Total Liabilities and Stockholders’ Equity
  $ 10,837,463     $ 9,030,802  
 
           
The accompanying notes are an integral part of these consolidated financial statements.

114


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
                 
    For the Years Ended  
    December 31,  
    2006     2005  
Revenues
  $ 12,799,132     $ 9,415,558  
Cost of revenues *
    7,925,086       5,680,379  
 
           
Gross profit
    4,874,046       3,735,179  
 
               
Operating expenses:
               
Selling, general and administrative expenses**
    3,829,489       2,449,460  
Depreciation and amortization
    1,373,318       751,257  
 
           
Total operating expenses
    5,202,807       3,200,717  
 
           
Income (loss) from operations
    (328,761 )     534,462  
 
               
Other (income) expenses:
               
Interest expense
    482,485       374,260  
ATE settlement
          (650,468 )
Other income
    (40,135 )      
 
           
 
    442,350       (276,208 )
 
           
Net income (loss)
  $ (771,111 )   $ 810,670  
 
               
Preferred stock dividend
    (35,500 )     (40,875 )
 
           
 
               
Net income (loss) applicable to common stockholders
  $ (806,611 )   $ 769,795  
 
           
 
               
Basic net income (loss) per share attributable to common stockholders
  $ (0.04 )   $ 0.04  
 
           
 
               
Diluted net income (loss) per share attributable to common stockholders
  $ (0.04 )   $ 0.04  
 
           
 
               
Weighted average common shares used in basic income (loss) per share
    22,875,017       19,857,233  
 
           
 
               
Weighted average common shares and dilutive securities used in diluted income (loss) per share
    22,875,017       20,691,501  
 
           
 
*   Excludes depreciation of $969,095 and $501,865 for the years ended December 31, 2006 and 2005, respectively.
 
**   Includes stock compensation charge of $240,000 for the year ended December 31, 2006.
The accompanying notes are an integral part of these consolidated financial statements.

115


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
                                 
    MSI Preferred Stock        
    Series A     MSI Common Stock  
Year Ended December 31, 2006   Shares     Amount     Shares     Amount  
Balance — December 31, 2005
    283,172     $ 283       22,228,980     $ 22,229  
MSI preferred stock converted into common stock
    (186,505 )     (186 )     186,505       186  
MSI common stock sold for cash net of transaction costs of $106,132
                429,500       430  
MSI common stock returned due to PIWS settlement
                (52,000 )     (52 )
MSI conversion price adjustment on convertible debt To Tate Investments, LLC
                       
MSI common stock issued for acquisition
                1,000,000       1,000  
Preferred stock dividend
                       
 
Net loss
                       
 
                       
Balance – December 31, 2006
    96,667     $ 97       23,792,985     $ 23,793  
 
                       
****************************
                                 
    Additional                    
    Paid-in     Accumulated     Treasury        
Year Ended December 31, 2006   Capital     Deficit     Stock     Total  
Balance — December 31, 2005
  $ 24,657,770     $ (22,482,408 )   $ (18,000 )   $ 2,179,874  
MSI preferred stock converted into common stock
                       
MSI common stock sold for cash net of transaction costs of $106,132
    702,438                   702,868  
MSI common stock returned due to PIWS settlement
    (38,948 )                 (39,000 )
MSI conversion price adjustment on Convertible debt to Tate Investments, LLC
    153,848                   153,848  
MSI common stock issued for acquisition
    879,000                   880,000  
MSI stock compensation charge
    240,000                       240,000  
Preferred stock dividend
    (35,500 )                 (35,500 )
Net loss
          (771,111 )           (771,111 )
 
                       
Balance – December 31, 2006
  $ 26,558,608     $ (23,253,519 )   $ (18,000 )   $ 3,310,979  
 
                       
The accompanying notes are an integral part of these consolidated financial statements.

116


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
                                 
    MSI Preferred Stock        
    Series A     MSI Common Stock  
Year Ended December 31, 2005   Shares     Amount     Shares     Amount  
Balance — December 31, 2004
    143,333     $ 143       18,515,755     $ 18,516  
MSI preferred stock sold for cash
    139,839       140              
MSI common stock sold for cash net of transaction costs of $50,443
                1,667,672       1,668  
MSI common stock issued for ATE settlement
                60,746       61  
MSI common stock returned by directors
                (20,000 )     (20 )
MSI common stock issued for debt conversions
                1,468,140       1,468  
MSI common stock issued for acquisitions
                536,667       536  
Preferred stock dividend
                       
 
                               
Net income
                       
 
                       
Balance – December 31, 2005
    283,172     $ 283       22,228,980     $ 22,229  
 
                       
****************************
                                 
    Additional                    
    Paid-in     Accumulated     Treasury        
Year Ended December 31, 2005   Capital     Deficit     Stock     Total  
Balance — December 31, 2004
  $ 21,595,239     $ (23,293,078 )   $ (18,000 )   $ (1,697,180 )
MSI preferred stock sold for cash
    209,618                   209,758  
MSI common stock sold for cash net of transaction costs of $50,443
    1,077,099                   1,078,767  
MSI common stock issued for ATE settlement
    83,006                   83,067  
MSI common stock issued for director fees
    100,689                   100,689  
MSI common stock returned by directors
    (2 )                 (22 )
MSI common stock issued for debt conversions
    1,228,532                   1,230,000  
MSI common stock issued for acquisitions
    404,464                   405,000  
Preferred stock dividend
    (40,875 )                 (40,875 )
 
                               
Net income
          810,670             810,670  
 
                       
Balance – December 31, 2005
  $ 24,657,770     $ (22,482,408 )   $ (18,000 )   $ 2,179,874  
 
                       
The accompanying notes are an integral part of these consolidated financial statements.

117


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
                 
    For the Years Ended  
    December 31,  
    2006     2005  
CASH FLOWS FROM OPERATING ACTIVITIES:
               
 
               
Net income (loss)
  $ (771,111 )   $ 810,670  
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
               
Depreciation and amortization
    1,373,318       751,258  
Provision for bad debts
    112,000       3,000  
Gain on ATE settlement
          (650,468 )
Litigation settlement
          (53,023 )
Stock compensation
    240,000       100,667  
Amortization of finance fees and debt discount
    29,527        
Cancellation of convertible debentures, advances from stockholders and related accrued interest
    (130,135 )      
Changes in assets (increase) decrease:
               
Accounts receivable
    (441,125 )     (375,950 )
Supplies
    12,247       (2,195 )
Prepaid expenses and other current assets
    95,565       128,244  
Other non-current assets
    (108,851 )     (64,335 )
Changes in liabilities increase (decrease)
               
Accounts payable, accrued liabilities & litigation settlements
    186,294       (959,282 )
 
           
NET CASH (USED IN) PROVIDED BY OPERATING ACTIVITIES
    597,729       (311,414 )
 
           
 
               
CASH FLOWS FROM INVESTING ACTIVITIES:
               
Additions to property and equipment
    (596,760 )     (225,713 )
Asset acquisition of On Call Medical Waste, Ltd.
          (375,000 )
Asset acquisition of Cooper Biomed, Ltd.
          (40,000 )
Asset acquisition of Positive Impact Waste Solutions
          (700,000 )
Asset acquisition of SteriLogic Waste Systems, Inc.
    (24,283 )      
 
           
NET CASH USED IN INVESTING ACTIVITIES
    (621,043 )     (1,340,713 )
 
           
 
               
CASH FLOWS FROM FINANCING ACTIVITIES:
               
Proceeds from sale of preferred stock
          209,758  
Proceeds from sale of common stock
    809,000       1,129,210  
Proceeds from note payable – stockholders
    1,150,000       1,375,000  
Cash paid for transaction costs associated with equity transactions
    (106,132 )     (50,443 )
Dividend on preferred stock
    (42,500 )     (37,250 )
Payments on long-term obligations to stockholders
    (1,516,833 )     (521,053 )
(Repayments to) advances from stockholders
    (19,005 )     (152,840 )
Payments on long-term obligations to others
    (251,216 )     (300,255 )
 
           
NET CASH PROVIDED BY FINANCING ACTIVITIES
    23,314       1,652,127  
 
           
 
               
NET INCREASE IN CASH AND CASH EQUIVALENTS
           
 
               
CASH AND CASH EQUIVALENTS — BEGINNING
           
 
           
 
               
CASH AND CASH EQUIVALENTS — END
  $     $  
 
           
The accompanying notes are an integral part of these consolidated financial statements.

118


Table of Contents

MEDSOLUTIONS, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
                 
    For the Years Ended  
    December 31,  
    2006     2005  
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION:
               
 
               
Interest paid
  $ 493,440     $ 430,803  
 
           
Income taxes paid
  $     $  
 
           
Issuance of notes payable for property & equipment
  $ 570,463     $ 601,518  
 
           
Common stock reclaimed in connection to clawback provision regarding the PIWS acquisition
    39,000        
 
           
Reduction in notes payable from PIWS purchase price settlement
  $ 130,000        
 
           
Notes payable converted into MSI common stock
  $     $ 775,843  
 
           
Accrued salaries and related interest converted into MSI common stock and stock options
  $     $ 454,157  
 
           
Insurance premiums financed with debt
  $ 169,363     $ 163,804  
 
           
Director fees paid with non plan stock options
  $     $ 100,667  
 
           
 
               
Net assets acquired and liabilities assumed (See Acquisitions Note 4)
               
 
Total purchase price
  $ 1,267,500     $ 3,150,900  
Less: cash consideration paid for acquisition
    (24,284 )     (1,115,000 )
Less: cash acquired
    (25,716 )      
 
           
Non-cash consideration
  $ 1,217,500     $ 2,035,900  
 
           
 
               
Short term note
  $     $ 740,000  
Long term note
    250,000       800,000  
Common stock issued
    880,000       405,000  
Acquisition costs
    87,500       90,900  
 
           
Allocation of non-cash consideration
  $ 1,217,500     $ 2,035,900  
 
           
The accompanying notes are an integral part of these consolidated financial statements.

119


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 1 DESCRIPTION OF BUSINESS
MedSolutions, Inc. (“MSI” or the “Company”) was incorporated in Texas in 1993, and through its subsidiary, EnviroClean Management Services, Inc. (“EMSI”), principally collects, transports and disposes of regulated medical waste in north Texas, south Texas, Oklahoma, Louisiana and Arkansas. MSI markets, through its wholly-owned subsidiary SharpsSolutions, Inc. (“Sharps”), a reusable sharps container service program to healthcare facilities that we expect will virtually eliminate the current method of utilizing disposable sharps containers. Another subsidiary of MSI, ShredSolutions, Inc. (“Shred”), markets a fully integrated, comprehensive service for the collection, transportation and destruction of Protected Healthcare Information (“PHI”) and other confidential documents, primarily those generated by health care providers and regulated under the Health Insurance Portability and Accountability Act (“HIPAA”). The Company operates another wholly owned subsidiary, Positive Impact Waste Servicing, Inc., which uses mobile treatment equipment to treat and dispose of regulated medical waste on site. Positive Impact Waste Servicing, Inc. was acquired by the Company’s from its asset acquisition from Positive Impact Waste Solutions, Ltd. (“PIWS”) on November 30, 2005. The assets acquired by the Company from PIWS included customer contracts and equipment. The Company operates another wholly owned subsidiary, SteriLogic Waste Systems, Inc. (“SteriLogic”), in Syracuse, New York which services RMW and Sharps customers in the New York and Pennsylvania markets. SteriLogic was acquired by the Company on August 21, 2006 and the stock acquisition included customer contracts, equipment and a rented facility in Syracuse, New York.
Liquidity and Capital Resources
Our principal source of liquidity is collections on accounts receivable from waste management service revenue, from sales of our Common and Preferred Stock through private offerings to certain individuals, primarily existing stockholders, and from loans and advances received from certain stockholders. Revenues during 2006 were approximately $282,000 per month higher, stemming primarily from organic growth and from an acquisition in the second half of 2006. The Company continues to pursue acquisition targets to expand its existing business. The principal uses of liquidity are payments for labor, fuel, material and expenses, and debt and lease obligations to carry out our regulated medical waste management services.
Historically, we have met our cash requirements based on a combination of revenues from operations, stockholder loans and advances, and proceeds from the sale of debt and equity securities. Based on the projected operations for 2007, management believes cash to be generated from operations and funds raised from other alternative sources if needed, will be sufficient to satisfy the Company’s historical and current cash obligations.

120


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Principles of Consolidation
The accompanying consolidated financial statements include the accounts of the Company, its subsidiaries, EMSI, SharpsSolutions, Inc., ShredSolutions, Inc., Positive Impact Waste Servicing, Inc. doing business as EnviroClean On-Site, Inc., SteriLogic Waste Systems, Inc. and EnviroClean Transport, Inc. All significant inter-company balances and transactions between the Company and its subsidiaries have been eliminated in consolidation.
Cash and Cash Equivalents
For purposes of the consolidated statement of cash flows, the Company considers all investments with an original maturity of three months or less to be cash equivalents.
Allowance for Doubtful Accounts
The Company’s trade accounts receivable is stated net of an allowance for doubtful accounts of $174,989 and $69,240 at December 31, 2006 and 2005, respectively. Our assumptions in determining the adequacy of the allowance for doubtful accounts include reviewing historical charge-offs over the previous two years, and analyzing current aging reports by performing a specific review of customer balances for possible payment problems. Based on our review, the allowance for doubtful accounts is adjusted accordingly.
Supplies
Supplies are stated at the lower of average cost or fair value and consist primarily of medical waste containers and supplies provided to our medical waste generator customers.
Property and Equipment
Property and equipment are stated at cost less appropriate valuation allowances and accumulated depreciation and amortization. Depreciation is provided on the straight-line method over the estimated useful lives of the related assets, generally three to twenty years. Amortization of leasehold improvements is provided on the straight-line method over the lesser of the estimated useful lives of the improvements or the initial term of the lease. Gain or loss is recognized upon sale or other disposition of property and equipment.

121


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
Goodwill and Intangible Assets
In accordance with the requirements of Statement of Financial Accounting Standards No. 141 (“SFAS No. 141”), “Business Combinations”, the Company recognizes certain intangible assets acquired in acquisitions, primarily goodwill and customer lists. To determine the adequacy of the carrying amounts on an ongoing basis, the Company, in accordance with the provisions of SFAS No. 142, “Goodwill and Other Intangible Assets”, performs its annual impairment test at the end of the year each December 31, unless triggering events indicate that an event has occurred which would require the test to be performed sooner. The Company monitors the performance of its intangibles by analyzing the expected future cash flows generated from such related intangibles to ensure their continued performance. If necessary, the Company may hire an outside independent consultant to appraise the fair value of such assets.
As of December 31, 2006, goodwill totaled $3,234,025. This amount is a result of seven acquisitions where goodwill was recorded in six of those acquisitions as part of the purchase price. With regard to the AmeriTech Environmental, Inc. (“ATE”) acquisition, closed on November 7, 2003, goodwill was recorded in the amount of $969,387. With regard to the B. Bray Medical Waste Service (“Bray”) acquisition, closed on January 1, 2004, goodwill was recorded in the amount of $3,600. Our third acquisition, Med-Con Waste Solutions, Inc. (“Med-Con”), was closed on September 30, 2004 and goodwill was recorded in the amount of $522,186. Our fourth acquisition, On Call Medical Waste, Ltd. (“On Call”), was closed on August 29, 2005 and goodwill was recorded in the amount of $653,922. Our sixth acquisition, Positive Impact Waste Solutions, Ltd. (“PIWS”) was closed on November 30, 2005 and goodwill was originally recorded in the amount of $447,926. The goodwill assigned to the PIWS acquisition was subsequently increased by $50,000 to $497,925 during the quarter ended September 30, 2006 due to additional estimated acquisition costs. Our seventh acquisition, SteriLogic was closed on August 21, 2006 and $756,004 was assigned to goodwill based upon an independent appraisal of the intangible assets acquired. All of the goodwill associated with these acquisitions is deductible for income tax purposes.
As of December 31, 2006, intangible assets associated with customer lists were $1,408,189 net of accumulated amortization of $1,028,993. All values assigned to customer list were derived by independent appraisals and were assigned lives of 5 years over which to amortize the assigned cost.

122


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
The amortization of customer lists for the 5 years ending December 31, 2011 is as follows:
         
Year Ended December 31,   Amount  
2007
  $ 440,125  
2008
    413,374  
2009
    302,246  
2010
    197,244  
2011
    55,200  
 
     
 
  $ 1,408,189  
 
     
Both the goodwill and customer list values are subject to an annual impairment test.
Amortization expense for the years ended December 31,2006 and 2005, was $404,223 and $249,392 respectively.
As of December 31, 2006, the Company determined there was no impairment of its goodwill or intangible assets.
Convertible Notes and Convertible Preferred
The Company accounts for conversion options embedded in convertible notes and convertible preferred stock in accordance with Statement of Financial Accounting Standard (“SFAS) No. 133 “Accounting for Derivative Instruments and Hedging Activities” (“SFAS 133”) and EITF 00-19 “Accounting for Derivative Financial Instruments Indexed to, and Potentially Settled in, a Company’s Own Stock” (“EITF 00-19”). SFAS 133 generally requires Companies to bifurcate conversion options embedded in convertible notes and preferred shares from their host instruments and to account for them as free standing derivative financial instruments in accordance with EITF 00-19. SFAS 133 provides for an exception to this rule when convertible notes and mandatorily redeemable preferred shares, as host instruments, are deemed to be conventional as that term is described in the implementation guidance provided in paragraph 61 (k) of Appendix A to SFAS 133 and further clarified in EITF 05-2 “The Meaning of “Conventional Convertible Debt Instrument” in Issue No. 00-19. SFAS 133 provides for an additional exception to this rule when the economic characteristics and risks of the embedded derivative instrument are clearly and closely related to the economic characteristics and risks of the host instrument.

123


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
The Company accounts for convertible notes (deemed conventional) and non-conventional convertible debt instruments classified as equity under EITF 00-19 “Accounting for Derivative Financial Instruments Indexed to, and Potentially Settled in, a Company’s Own Stock” (“EITF 00-19”)and in accordance with the provisions of Emerging Issues Task Force Issue (“EITF”) 98-5 “Accounting for Convertible Securities with Beneficial Conversion Features,” (“EITF 98-5”), EITF 00-27 “Application of EITF 98-5 to Certain Convertible Instruments.” Accordingly, the Company records, as a discount to convertible notes, the intrinsic value of such conversion options based upon the differences between the fair value of the underlying common stock at the commitment date of the note transaction and the effective conversion price embedded in the note. Debt discounts under these arrangements are amortized over the term of the related debt to their earliest date of redemption. During 2005, the Company issued $1,000,000 in principal of convertible notes with an embedded conversion option, which was classified as equity. There was no intrinsic value related to the embedded conversion option and accordingly, there was no recorded debt discount.
The Company determined that the conversion option embedded in its Series A Preferred stock is not a free standing derivative in accordance with the implementation guidance provided in paragraph 61 (l) of Appendix A to SFAS 133.
Impairment of Long-Lived Assets
The Company continuously monitors events and changes in circumstances that could indicate carrying amounts of long-lived assets, including intangible assets, may not be recoverable. An impairment loss is recognized when expected cash flows are less than the assets’ carrying value. Accordingly, when indicators of impairment are present, the Company evaluates the carrying value of such assets in relation to the operating performance and future undiscounted cash flows of the underlying business. The Company’s policy is to record an impairment loss when it is determined that the carrying amount of the asset may not be recoverable. At December 31, 2006, there were no indicators of impairment present.
Revenue Recognition and Processing Costs
We recognize revenue for our medical waste services at the time the medical waste is collected from our customers. Revenue is only recognized for arrangements with customers in which (1), there is persuasive evidence of a contract or agreement which sets forth the terms of the arrangement; (2), services have been rendered; (3), our prices are fixed, determinable and agreed upon; and, (4), collectibility is reasonably assured.

124


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
Fair Value of Financial Instruments
The recorded carrying values of accounts receivable, accounts payable, and other long-term obligations are considered to approximate the fair values of such financial instruments because of the short maturities.
Provisions for Income Taxes
No provisions have been made for federal or state income taxes since the Company has incurred net operating losses since its inception. The Company is subject to certain local minimum taxes.
Stock-Based Compensation
Effective January 1, 2006, the Company adopted SFAS 123R which replaces SFAS 123, “Accounting for Stock-Based Compensation” and supersedes Accounting Principles Board Opinion No. 25, “Accounting for Stock Issued to Employees.” SFAS 123R requires all share-based payments to employees, including grants of employee stock options, to be recognized in the financial statements based on their fair values. Pro forma disclosure is no longer an alternative to financial statement recognition.
The Company has selected the Black-Scholes method of valuation for share-based compensation and has adopted the modified prospective transition method under SFAS 123R, which requires that compensation cost be recorded, as earned, for all unvested stock options outstanding as of the beginning of the first quarter of adoption of SFAS 123R. As permitted by SFAS 123R, prior periods have not been restated. The charge is generally recognized as compensation cost on a straight-line basis over the remaining service period after the adoption date based on the options’ original estimate of fair values.
Prior to the adoption of SFAS 123R, the Company applied the intrinsic-value-based method of accounting prescribed by APB 25 and related interpretations, to account for its stock options to employees. Under this method, compensation cost was recorded only if the market price of the underlying stock on the date of grant exceeded the exercise price. As permitted by SFAS 123, the Company elected to continue to apply the intrinsic-value-based method of accounting described above, and adopted only the disclosure requirements of SFAS 123. The fair-value-based method used to determine historical pro forma amounts under SFAS 123 was similar in most respects to the method used to determine stock-based compensation expense under SFAS 123R.

125


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
         
Periods Ended December 31, 2005 (in thousands)   2005  
Net income (loss) applicable to common stockholders, Prior to stock-based employee compensation
  $ 770  
Stock-based employee compensation cost
     
 
     
Net income (loss) applicable to common stockholders, as reported
  $ 770  
Stock-based employee compensation cost determined under fair value method, net of tax effects
    (291 )
 
     
Pro-forma net income (loss) under fair value method – Basic
  $ 479  
Effect of dilutive securities
       
Preferred Stock
    41  
Convertible notes payable and advances interest expense
    45  
Pro-forma net income (loss) under fair value method – Dilutive
  $ 565  
 
     
Net income (loss) per share applicable to common stockholders – Basic
  $ 0.04  
Stock-based employee compensation cost determined under fair value method, net of tax effects
    (0.01 )
Pro-forma loss per share applicable to common stockholders- Basic
  $ 0.03  
 
     
Net income (loss) per share applicable to common stockholders- Diluted
  $ 0.04  
Stock-based employee compensation cost determined under fair value method, net of tax effects
    (0.01 )
Pro-forma net income (loss) per share attributable to common stockholder– Diluted
  $ 0.03  
 
     

126


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
The fair value of each option grant was estimated at the date of grant using the Black-Scholes option valuation model. The Black-Scholes option valuation model was developed for use in estimating the fair value of traded options which have no vesting restrictions and are fully transferable. During the year ended December 31, 2006 and 2005, the Company granted 478,796 and 674,336 stock options,(fair value $0.00 and $0.51 per share for 2006 and 2005, respectively) respectively to employees under an adopted 2002 Employee Stock Option Plan. The exercise prices of the stock options were $0.75 and $1.00 and vest immediately. The options may be exercised over a period of ten years. The Company recorded a non cash charge of $240,000 during the year ended December 31, 2006 because the options granted in 2005 to executives exceeded the authorized amount of options to grant that was in effect as of December 31, 2005. The authorized amount was increased from 850,000 shares to 3,000,000 shares in October, 2006 by a majority of the Company’s shareholders. Because the Company’s stock options have characteristics significantly different from those of traded options, and because changes in the subjective input assumptions can materially affect the fair value estimate, in management’s opinion, the existing models do not necessarily provide a reliable single measure of the fair value estimate of its stock options. During the years ended December 31, 2006 and 2005, respectively, the Company granted its directors 0 and 215,431, plan stock options, respectively. The options were granted in lieu of payment of director fees. The total number of stock options outstanding as of December 31, 2006 and 2005, was 1,328,796. In calculating the fair values of the stock options, the following assumptions were used:
                 
    YEAR   YEAR
    2006 GRANTS   2005 GRANTS
Dividend yield
           
Weighted average expected life:
  5 years   5 years
Weighted average risk-free interest rate
    4.75 %     4.25 %
Expected volatility
    101.00 %     92.00 %
Income (Loss) Per Share of Common Stock
Basic net income (loss) per share of common stock has been computed based on the weighted average number of common shares outstanding during the periods presented.
Diluted net income per share of common stock has been computed based on the weighted average number of common shares outstanding during the periods presented plus any dilutive securities outstanding unless such combination of shares and dilutive securities were determined to be anti-dilutive. The numerator and denominator for basic and diluted earnings per share (“EPS”) consist of the following:

127


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
                 
    2006     2005  
Numerator:
               
Net income (loss)
  $ (771,111 )   $ 810,670  
Convertible preferred stock dividends
    (35,500 )     (40,875 )
 
           
Numerator for basic earnings per share – income available to common stockholders
  $ (806,611 )   $ 769,795  
 
               
Effect of dilutive securities:
               
Preferred stock dividends
          40,875  
Convertible notes payable and advances interest expense
          44,987  
 
           
 
  $     $ 85,862  
 
           
Numerator for diluted earnings per share – income available to common stockholders after assumed conversions
  $ (806,611 )   $ 855,657  
Denominator:
               
Denominator for basic earnings per share – weighted average shares
    22,875,017       19,857,233  
Effect of dilutive securities:
               
Convertible accrued salaries
          35,060  
Preferred convertible stock
          250,528  
Convertible debentures and unpaid interest
          58,334  
Note payable to stockholders and accrued interest
          34,283  
Note payable to Tate Investments, LLC
          407,070  
Advances from stockholders
          48,992  
 
           
Total potentially dilutive securities
          834,267  
 
               
Denominator for diluted earnings per share – adjusted weighted average shares and assumed conversions
    22,875,017       20,691,500  
 
           
Basic earnings per share
  $ (0.04 )   $ 0.04  
 
           
Diluted earnings per share
  $ (0.04 )   $ 0.04  
 
           
For the year ended December 31, 2005, 850,000 shares attributable to outstanding stock options were excluded from the calculation of diluted earnings per share because the exercise prices of the stock options were greater than or equal to the average price of the common shares ($0.75), and therefore their inclusion would have been anti-dilutive. For the year ended December 31, 2006, common stock equivalents totaling 4,216,035 that consisted of options, convertible preferred shares and convertible notes were not included in the calculation of diluted loss per share because their inclusion would have had the effect of decreasing the loss per share otherwise compute.

128


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)
Advertising Expenses
Advertising costs are charged to expense when incurred. Advertising expense for the years ended December 31, 2006 and 2005 approximated $28,991 and $20,256, respectively.
Environmental Expenditures
Environmental expenditures are capitalized if the costs mitigate or prevent future environmental contamination or if the costs improve existing assets’ environmental safety or efficiency. All other environmental expenditures are expensed. Liabilities for environmental expenditures are accrued when it is probable that such obligations have been incurred and the amounts can be reasonably estimated. Currently, there are no ongoing environmental issues or activities. At December 31, 2006 and 2005, there have been no amounts recorded as capitalized assets related to any environmental costs.
Use of Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the related periods. Actual results could differ from such estimates.
NOTE 3 RECENTLY ISSUED ACCOUNTING STANDARDS
The following pronouncements have been issued by the Financial Accounting Standards Board (“FASB”).
In February 2006, the Financial Accounting Standards Board (“FASB”) issued Statement of Financial Accounting Standard 155 “Accounting for Certain Hybrid Financial Instruments” (“SFAS 155”), which eliminates the exemption from applying SFAS 133 “Accounting for Derivative Instruments and Hedging Activities” (“SFAS 133”) to interests in securitized financial assets so that similar instruments are accounted for similarly regardless of the form of the instruments. SFAS 155 also allows the election of fair value measurement at acquisition, at issuance, or when a previously recognized financial instrument is subject to a remeasurement event. Adoption is effective for all financial instruments acquired or issued after the beginning of the first fiscal year that begins after September 15, 2006. Early adoption is permitted. The adoption of SFAS 155 is not expected to have a material effect on the Company’s consolidated financial position, results of operations or cash flows.

129


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 3 RECENTLY ISSUED ACCOUNTING STANDARDS (continued)
In March 2006, the FASB issued Statement of Financial Accounting Standard 156 “Accounting for Servicing of Financial Assets” (“SFAS 156”), which requires all separately recognized servicing assets and servicing liabilities be initially measured at fair value. SFAS 156 permits, but does not require, the subsequent measurement of servicing assets and servicing liabilities at fair value. Adoption is required as of the beginning of the first fiscal year that begins after September 15, 2006. Early adoption is permitted. The adoption of SFAS 156 is not expected to have a material effect on the Company’s consolidated financial position, results of operations or cash flows.
In July 2006, the FASB released FASB Interpretation No. 48 (“FIN 48”), “Accounting for Uncertainty in Income Taxes, an interpretation of FASB Statement No. 109.” FIN 48 clarifies the accounting and reporting for uncertainties in income tax law. FIN 48 prescribes a comprehensive model for the financial statement recognition, measurement, presentation and disclosure of uncertain tax positions taken or expected to be taken in income tax returns. FIN 48 is effective for fiscal years beginning after December 15, 2006. Earlier adoption is permitted as of the beginning of an enterprise’s fiscal year, provided the enterprise has not yet issued financial statements, including financial statements for any interim period for that fiscal year. The cumulative effects, if any, of applying FIN 48 will be recorded as an adjustment to retained earnings as of the beginning of the period of adoption. The adoption of FIN 48 is not expected to have a material effect on the Company’s consolidated financial position, results of operations or cash flows.
In September 2006, the FASB issued SFAS No. 157, “Accounting for Fair Value Measurements” (“SFAS 157”). SFAS 157 defines fair value, and establishes a framework for measuring fair value in generally accepted accounting principles and expands disclosure about fair value measurements. SFAS 157 is effective for financial statements issued by the Company for fiscal years beginning after November 15, 2007. The Company does not expect the new standard to have a material impact on the Company’s financial position, results of operations or cash flows.
In September 2006, the FASB issued SFAS No. 158, “Employers’ Accounting for Defined Benefit Pension and Other Postretirement Plans” (“SFAS 158”). SFAS 158 requires an employer to recognize the overfunded or underfunded status of a defined benefit postretirement plan (other than a multiemployer plan) as an asset or liability in its statement of financial position and to recognize changes in that funded status in the year in which the changes occur through comprehensive income of a business entity or changes in unrestricted net assets of a not-for-profit organization. SFAS 158 also requires an employer to measure the funded status of a plan as of the date of its year-end statement of financial position, with limited exceptions. SFAS 158 is effective for the Company for the year ended December 31, 2006. The adoption of this pronouncement did not have a material effect on the Company’s financial statements.

130


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 3 RECENTLY ISSUED ACCOUNTING STANDARDS (continued)
In September 2006, the staff of the Securities and Exchange Commission issued Staff Accounting Bulletin No. 108 (“SAB 108”), which provides interpretive guidance on how the effects of the carryover or reversal of prior year misstatements should be considered in quantifying a current year misstatement. SAB 108 becomes effective for the first fiscal year ending after November 15, 2006. The adoption of SAB 108 is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.
In December 2006, the FASB approved FASB Staff Position (FSP) No. EITF 00-19-2, “Accounting for Registration Payment Arrangements” (“FSP EITF 00-19-2”), which specifies that the contingent obligation to make future payments or otherwise transfer consideration under a registration payment arrangement, whether issued as a separate agreement or included as a provision of a financial instrument or other agreement, should be separately recognized and measured in accordance with SFAS No. 5, “Accounting for Contingencies”. FSP EITF 00-19-2 also requires additional disclosure regarding the nature of any registration payment arrangements, alternative settlement methods, the maximum potential amount of consideration and the current carrying amount of the liability, if any. The guidance in FSP EITF 00-19-2 amends FASB Statements No. 133, “Accounting for Derivative Instruments and Hedging Activities”, and No. 150, “Accounting for Certain Financial Instruments with Characteristics of both Liabilities and Equity”, and FASB Interpretation No. 45, “Guarantor’s Accounting and Disclosure Requirements for Guarantees, Including Indirect Guarantees of Indebtedness of Others”, to include scope exceptions for registration payment arrangements.
FSP EITF 00-19-2 is effective immediately for registration payment arrangements and the financial instruments subject to those arrangements that are entered into or modified subsequent to the issuance date of this FSP, or for financial statements issued for fiscal years beginning after December 15, 2006, and interim periods within those fiscal years, for registration payment arrangements entered into prior to the issuance date of this FSP. The adoption of this pronouncement is not expected to have an impact on the Company’s consolidated financial position, results of operations or cash flows.
In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities” (“SFAS 159”). SFAS 159 provides companies with an option to report selected financial assets and liabilities at fair value. The objective of SFAS 159 is to reduce both complexity in accounting for financial instruments and the volatility in earnings caused by measuring related assets and liabilities differently. Generally accepted accounting principles have required different measurement attributes for different assets and liabilities that can create artificial volatility in earnings. The FASB has indicated it believes that SFAS 159 helps to mitigate this type of accounting-induced volatility by enabling companies to report related assets and liabilities at fair value, which would likely reduce the need for companies to comply with detailed rules for hedge accounting. SFAS 159 also establishes presentation and disclosure requirements designed to

131


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 3 RECENTLY ISSUED ACCOUNTING STANDARDS (continued)
facilitate comparisons between companies that choose different measurement attributes for similar types of assets and liabilities. SFAS 159 does not eliminate disclosure requirements included in other accounting standards, including requirements for disclosures about fair value measurements included in SFAS 157 and SFAS No. 107, “Disclosures about Fair Value of Financial Instruments.” SFAS 159 is effective for the Company as of the beginning of fiscal year 2009. The Company has not yet determined the impact SFAS 159 may have on its consolidated financial position, results of operations, or cash flows.
NOTE 4 ACQUISITIONS
Med-Con Waste Solutions, Inc. (“Med-Con”)
At December 31, 2006, the Company owed $274,749 in two promissory notes to Med-Con as payment for part of the purchase price for the Company’s acquisition of certain Med-Con assets completed on September 30, 2004. The first promissory note has a balance of $235,749 as of December 31, 2006 and accrues interest at 8%. The Company pays monthly installments of $8,696 including principal and interest and the note matures on May 1, 2009. The second promissory note has a balance of $39,001 as of December 31, 2006 and accrues interest at 10%. The Company pays monthly installments of $6,691 including principal and interest and the note matures on May 1, 2007.
On Call Medical Waste Service (“On Call”)
On August 29, 2005, we acquired certain assets including customer contracts from On Call for a total purchase price of $1,155,500. The purchase price for the acquired assets was (i) $375,000 cash, (ii) a promissory note in the original principal amount of $250,000 bearing interest at a rate per annum of 8%, payable in 24 equal monthly installments of principal and interest with the first such installment due on December 27, 2005, (iii) a promissory note in the original principal amount of $375,000 with no interest, (iv) 166,667 shares of Common Stock, and (v) $30,500 of transaction costs incurred by the Company. The cash portion of the purchase price was funded from the proceeds of a sale of the Company’s Common Stock in a private placement to, and a loan to the Company pursuant to a promissory note from, one of its shareholders.
Positive Impact Waste Solutions, Ltd. (“PIWS”)
On November 30, 2005, the Company acquired certain assets, including customer contracts, and took over the regulated medical waste operations of Positive Impact Waste Solutions, LLC, a Delaware limited liability company (“PIWS”). Subsequent to the Company’s acquisition of PIWS’ assets, it was determined that PIWS had not complied with certain terms of the asset purchase agreement (the “PIWS Agreement”). On June 30, 2006, a settlement was reached and executed between the Company and PIWS relating to such noncompliance. As a result of this noncompliance and in accordance with the terms of the PIWS Agreement, a reduction of the total purchase price by $169,000 was agreed to by both parties. The purchase price adjustment reduced the amount assigned to customer list by $169,000. The goodwill assigned to the PIWS acquisition was subsequently increased by $50,000 to $497,925 during the quarter ended September 30, 2006 due to additional estimated acquisition costs.

132


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 4 ACQUISITIONS (continued)
At December 31, 2006, the Company owed $431,501 in a promissory note to PIWS as payment for part of the purchase price. The promissory note accrues interest at 8% and the Company pays monthly installments of $10,725 including principal and interest. The note matures on November 30, 2010.
Cooper Biomed, Ltd. (“Cooper”)
On September 30, 2005, we acquired certain assets, principally customer contracts, from Cooper. On March 31, 2006, the Company calculated a purchase price reduction of $8,500 in accordance with the asset purchase agreement and reduced the $40,000 promissory note to Cooper accordingly. The promissory note has subsequently been paid and all obligations of the Company to Cooper pursuant to such agreement have been satisfied. The cash portion of the purchase price was funded from the proceeds of a sale of the Company’s Common Stock in a private placement to, and a loan to the Company pursuant to a promissory note from, one of its stockholders. As provided for in the agreement the Company calculated a $8,500 purchase price adjustment and reduced the principal due under the $25,000 promissory note and the amount assigned to customer list, accordingly.
SteriLogic Waste Systems, Inc. (“SteriLogic”)
On August 16, 2006, MedSolutions, Inc., a Texas corporation (the “Company”), acquired SteriLogic Waste Systems, Inc., a Pennsylvania corporation (“SteriLogic”) located in Syracuse, New York. SteriLogic is a regulated medical waste management company that provides collection, transportation and disposal of regulated medical waste services in addition to providing reusable sharps container programs to its customers who are primarily located in the states of New York and Pennsylvania. SteriLogic also designs, manufactures and markets reusable sharps containers to medical waste service providers who provide reusable sharps container programs to their medical waste customers.
The acquisition was effected pursuant to a Merger Agreement and Plan of Reorganization dated as of August 16, 2006, by and between the Company, SteriLogic Acquisition Subsidiary, Inc., a Texas corporation and wholly-owned subsidiary of the Company (“Subsidiary”), and SteriLogic, by the merger (the “Merger”) of SteriLogic with and into Subsidiary, with Subsidiary continuing as the surviving corporation. At the effective time of the Merger, each share of SteriLogic common stock, par value $0.01 per share, issued and outstanding immediately prior to such time was converted into the right to receive 200 shares of the Company’s common stock, par value $0.001 per share (“Merger Shares”), for an aggregate of 1,000,000 Merger Shares.

133


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 4 ACQUISITIONS (continued)
In addition, the Company paid Abele-Kerr Investments, LLC (i) $50,000 in readily available funds, and (ii) a convertible promissory note in the principal amount of $250,000 with simple interest at the annual rate of 8% accruing from the effective time and payable in 12 equal installments of interest only in the amount of $1,666.67 each due monthly beginning on the 30th day after the effective time, and 24 equal installments of principal and interest in the amount of $11,306.82 each due monthly thereafter. The note holder may convert the unpaid principal and interest at any time, but prior to August 16, 2007, into the Company’s common stock at $1.50 per share. The Merger consideration may be adjusted downward depending upon the amount of sales or earnings realized by the Company from the customer contracts acquired through the acquisition of SteriLogic for the 12 months following the closing of the transaction. Any such adjustment to the Merger consideration will be deducted 25% from the principal amount of the $250,000 promissory note, and 75% from the Merger Shares, pro rata against each former holder of SteriLogic common stock that received Merger Shares in proportion to the percentage of the Merger Shares received by each such holder, at the rate of $1.50 per share; provided, that the Company may not deduct more than 400,000 Merger Shares with respect to the adjustment. The cash portion of the Merger consideration was funded from working capital. The Merger consideration was determined largely based upon the amount of revenues SteriLogic has generated from its regulated medical waste disposal business and the value of the net assets acquired.
On January 15, 2007, the former owners of SteriLogic and the Company agreed by mutual consent to amend the original Merger Agreement whereby the former owners of SteriLogic agreed to reduce the number of Merger Shares issued by the Company from 1,000,000 to 700,000 shares and to terminate the conversion feature of the $250,000 promissory note issued by the Company as part of the purchase price. As a result of these amendments, the Company recorded a reduction in the purchase price with regard to the SteriLogic acquisition by $264,000 reflecting the return of the 300,000 shares issued by the Company. The corresponding reduction reduced the value assigned to SteriLogic’s customer list by $264,000.

134


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 4 ACQUISITIONS (continued)
MedSolutions purchased the following assets in the following table in exchange for the amount paid.
         
Description   Amount  
Purchase price:
       
 
       
Cash paid
  $ 50,000  
Promissory note
    250,000  
MSI Common Stock issued, 1,000,000 shares
    880,000  
Acquisition related costs
    87,500  
 
     
Total purchase price
  $ 1,267,500  
 
     
 
       
Assets acquired and liabilities assumed:
       
 
       
Cash
  $ 25,716  
Accounts Receivable, Inventory, and other assets
    155,336  
Equipment at Fair Value
    100,000  
Liabilities assumed
    (321,557 )
Allocation to customer list, to be amortized over 5 years
    552,000  
Allocation to goodwill
    756,005  
 
     
Total assets acquired
  $ 1,267,500  
 
     

135


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 4 ACQUISITIONS (continued)
Pro Forma Results
The following table presents the unaudited pro-forma combined results of operations of the Company for its 2006 results and acquisitions as if they had been combined from the beginning of 2006 and 2005.
                 
    Pro forma Combined     Pro forma Combined  
    For the year ended     for the year ended  
    December 31, 2006     December 31, 2005  
Revenues:
               
Net Sales
  $ 13,381,088     $ 12,124,379  
 
           
Net income (loss)
  $ (670,674 )   $ 157,744  
 
           
Basic net income (loss) per common share
  $ (0.03 )   $ 0.01  
 
           
Diluted net income (loss) per common share
  $ (0.03 )   $ 0.01  
 
           
Weighted average common shares outstanding – basic
    23,499,674       21,296,703  
 
           
Weight average common shares outstanding — diluted
    23,499,674       22,130,972  
 
           
The pro forma combined results are not necessarily indicative of the results that actually would have occurred if the acquisition had been completed as of the beginning of the 2006 and 2005 years, nor are they necessarily indicative of future consolidated results.

136


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 5 PROPERTY AND EQUIPMENT
Property and equipment consisted of the following:
                         
    At December 31,        
    2006     2005     Useful Life  
Land
  $ 151,180     $ 151,180        
Building
    1,124,276       1,050,711     20 years  
Furniture and equipment
    5,117,161       3,785,369       3 to 5 years  
 
                   
 
    6,392,617       4,987,260          
Less: Accumulated depreciation
    2,805,851       1,836,756          
 
                   
Property and Equipment, Net
  $ 3,586,766     $ 3,150,504          
 
                   
Depreciation of property and equipment for the years ended December 31, 2006 and 2005 amounted to $969,095 and $501,685, respectively.
NOTE 6 INCOME TAXES
The current year’s Federal and State income tax provision consists substantially of minimum taxes. The principal reasons for the variation between income taxes at the statutory federal rate and that shown in the statement of operations were as follows:
                 
    Years Ended  
    2006     2005  
Statutory federal income tax rate
    34.0 %     34.0 %
State income taxes, net of federal income tax benefit
    6.0 %     6.0 %
Adjustment for change in valuation allowance
    (40.0 )     (40.0 %)
 
           
 
           
 
           
Temporary differences between the financial statement and tax basis of assets and liabilities which give rise to a significant portion of deferred tax assets and deferred tax liabilities were as follows:

137


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 6 INCOME TAXES (continued)
                 
    Year Ended  
    2006     2005  
Deferred Tax Assets:
               
Operating loss carryforwards
  $ 8,000,000     $ 7,500,000  
Accounts receivable allowance
    70,000       28,000  
 
           
Total Tax Assets
  $ 8,070,000     $ 7,528,000  
 
           
 
               
Deferred Tax Liabilities:
               
Fixed Assets
  $ 286,000     $ 238,000  
Goodwill and intangibles
    409,000       213,000  
 
           
Total Tax Liabilities
    695,000       451,000  
Less- Valuation Allowance
    (7,375,000 )     (7,077,000 )
 
           
Net Deferred Tax Asset
  $     $  
 
           
The valuation allowance primarily relates to the Federal and State net operating losses for which utilization in future periods is uncertain. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers projected future taxable income and tax planning strategies in making this assessment. Based on the historical taxable income and projections for future taxable income over the periods that the deferred tax assets are deductible, the Company believes it is more likely than not that the Company will not realize all of its tax benefits in the near future and therefore a valuation allowance was established in 2006 in the amount of $7,375,000.
As of December 31, 2006 the Company has approximately $19.9 million of federal and state net operating losses available to offset future taxable income, which if not utilized will expire through 2025. The Company’s ability to utilize its carryforwards may be subject to an annual limitation in future periods pursuant to Section 382 of the Internal Revenue Code, as amended.

138


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 7 ACCRUED LIABILITIES
Accrued liabilities consist of the following:
                 
    At December 31,  
    2006     2005  
Salaries and other taxes
  $ 347,545     $ 244,268  
Accrued director fees
    269,891        
Interest
    27,408       116,598  
Insurance
    169,363       254,042  
Other accrued liabilities
    467,236       347,419  
 
           
 
  $ 1,281,443     $ 962,327  
 
           

139


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 8 LONG-TERM OBLIGATIONS
Long-term obligations are comprised of the following:
                 
    At December 31,  
    2006     2005  
Bank notes — EMSI facilities
  $ 511,465     $ 505,216  
Installment notes – equipment
    864,261       447,364  
 
           
Total indebtedness to bank and financial institutions
    1,375,726       952,580  
 
               
Less: Current maturities
    372,552       145,628  
 
           
Total Long-Term Obligations
  $ 1,003,174     $ 806,952  
 
           
On August 9, 2006, the Company, through its subsidiary EMSI, secured additional financing from a bank to expand its Houston facility. The facility is currently being used as a transfer facility for the South Texas operations. The expansion will allow EMSI to treat medical waste at the facility once the permitting process is completed from the state of Texas. The total costs of expansion will be approximately $275,000 with $200,000 of those funds coming from bank financing and the remainder from working capital. The promissory note to the bank is payable in 60 monthly installments of $822 in principal plus interest accruing at the Prime Rate as published in the Wall Street Journal from time to time plus 1%, with the balance of the principal and all accrued and unpaid interest due upon maturity of the loan on July 19, 2011. The note is secured by a second lien on the Houston facility and is personally guaranteed by both our President/Chief Executive Officer and our Chairman of the Board. As of December 31, 2006, the Company has drawn $55,634 against the promissory note and the funds were used for the commencement phase of expansion. The amount outstanding at December 31, 2006 is $52,347 and the net carrying value of our Houston facility is approximately $370,000.
On August 3, 2005, the Company, through its subsidiary EMSI, borrowed $325,000 from a bank. The note is secured by a first lien on EMSI’s facility in Houston, Texas and accrues interest at a variable rate based on the national prime rate, plus 2.0%, aggregating 10.25% at December 31, 2006. The note is payable in 60 minimum monthly installments of $3,656, including principal and interest, based upon a straight line amortization of 240 payments, and matures on August 3, 2010, with a balloon payment of $243,750. The promissory note is personally guaranteed by our President/Chief Executive Officer. The total amount outstanding at December 31, 2006 is $303,333.
In July 1996, the Company borrowed $367,500 from a bank. The note is secured by a first lien on EMSI’s facility in Garland, Texas, and accrues interest at a variable rate based on the national prime rate, plus 0.5%, aggregating 8.75% at December 31, 2006. The note is payable in minimum monthly installments of principal and interest totaling $3,459 and matures in July 2011. The promissory note is personally guaranteed by our President/Chief Executive Officer. The total amount outstanding at December 31, 2006 is $155,785 and the net carrying value of the Garland facility is approximately $263,000.

140


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
     NOTE 8 LONG-TERM OBLIGATIONS (continued)
     The Company is obligated under various installment notes payable for the purchase of equipment with an aggregate cost of $864,261. The notes, which bear interest at rates ranging from 8.0% to 16.1%, are due at various dates through 2011 and are payable in monthly installments totaling approximately $30,549 consisting of principal and interest. The equipment acquired collateralizes the notes.
Aggregate maturities of long-term indebtedness (including the notes payable — stockholders described in Note 9 below) at December 31, 2006 are as follows:
         
Year Ended December 31,   Amount  
2007
  $ 1,351,050  
2008
    1,845,110  
2009
    1,047,873  
2010
    531,812  
2011 and thereafter
    64,538  
 
     
Total Annual Payments
  $ 4,840,383  
 
       
Less: Debt Discount
    102,564  
 
     
Total (Net of Discount)
  $ 4,737,819  
 
     

141


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 9 NOTES PAYABLE – STOCKHOLDERS
On March 15, 2006, the Company issued a convertible promissory note in the amount of $500,000 to Tate Investments LLC (“the Investor”). The promissory note is payable in 35 monthly installments of interest only with all principal and interest due on March 31, 2009. The note accrues interest at 10% for the first 12 months, 11% for months 13 through 24 and 12% for months 25 through maturity. The effect of the increasing interest rate under EITF 86-15 “Increasing-Rate Debt” was determined to be de minimus. The Company may prepay a portion or all of the amount outstanding under the terms of the note after March 31, 2007, provided that the Company notify the Investor of the Company’s intent to prepay after which, the Investor will have 30 days to convert the note into the Company’s Common Stock. The Investor has the right to convert the amount outstanding plus accrued but unpaid interest at the time of conversion. The conversion price agreed to is $0.85 per share during the period beginning March 15, 2006 through March 31, 2007, $1.00 per share during the period beginning April 1, 2007 through March 31, 2008, and $1.15 per share during the period April 1, 2008 through maturity. The promissory note is secured by two PIWS mobile units, with a net carrying value of $271,867 and is cross-collateralized by the Investor’s liens on the Company’s accounts receivable and its Garland facility pursuant to the Investment Agreement dated July 15, 2005, between the Company and the Investor (“Investment Agreement”). The proceeds from the promissory note were used by the Company to purchase equipment.
On May 22, 2006, the Company and the Investor agreed to amend the Investment Agreement to lower the conversion price for the $1,000,000 Promissory Note to $0.55 per share from $0.65 per share in exchange for the Investor retroactively (as of July 15, 2005, the date the Investment Agreement was executed) eliminating the requirements for the Company to achieve certain earnings targets thereunder. In connection with the conversion price adjustment, the Company was required to record a beneficial conversion charge of $153,846. The beneficial conversion charge represents the incremental fair value of the impact from lowering the conversion rate and will be amortized over the remaining life of the note. The note accrues interest at 10% and matures on July 15, 2008 when all outstanding principal and accrued interest is due. As of December 31, 2006, the remaining amount of the beneficial conversion charge to amortize was $102,564.
As of December 31, 2006, the total principal amount owed by the Company to the Investor was $1,397,436, net of discount of $102,564.
On October 3, 2006, the Company issued a convertible promissory note to our Chairman of the Board who loaned $100,000 for the purpose of providing working capital to the Company. The promissory note is payable in interest only monthly installments for three months and afterwards, it begins paying 24 equal monthly installments of principal and interest in the amount of $4,707 each. The note accrues interest at 12% and at the option of the holder, any unpaid principal and accrued interest may be converted into Common Stock at the conversion price of $1.00 per share. The note matures on January 3, 2009 at which time all unpaid principal and accrued interest thereon is due.
On December 28, 2006, the Company issued a promissory note to our Chairman of the Board who loaned $175,000 for the purpose of providing equipment financing to the Company. The promissory note is payable in 24 equal monthly installments of principal and interest in the amount of $5,813 each. The note accrues interest at 12% and matures on December 28, 2008.

142


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 9 NOTES PAYABLE – STOCKHOLDERS (continued)
On October 3, 2006, the Company issued a convertible promissory note to one of our directors/shareholders who loaned $100,000 for the purpose of providing working capital to the Company. The promissory note is payable in interest only monthly installments for 24 months at $1,000 per installment. The note accrues interest at 12% and at the option of the holder, any unpaid principal and accrued interest may be converted into Common Stock at the conversion of $1.00 per share. The note matures on October 3, 2008.
NOTE 10 EXTINGUISHMENT OF CONVERTIBLE DEBENTURES
The Company issued an aggregate of $1,100,000 of 15% Convertible Redeemable Subordinated Debentures (the “Series I Debentures”) in 1994 and 1995 with a final maturity date of March 31, 1999, and containing a provision for conversion of the Series I Debentures, at the option of the holders thereof, into shares of Common Stock. The Company also issued an aggregate of $256,125 of 10% Convertible Redeemable Debentures (“Series II Debentures,” and together with the Series I Debentures, the “Debentures”) in 1998 with a maturity date of November 1, 1999, and containing a provision for conversion of the Series II Debentures, at the option of the holders thereof, into shares of Common Stock.
Due to cash constraints, the Company was not able to redeem the Debentures in 1999 pursuant to their respective terms. The Company offered (the “Conversion Offering”) the holders of the Debentures the opportunity to convert their Series I Debentures and Series II Debentures into shares of Common Stock at a conversion rate of $1.50 and $1.75, respectively.
Certain holders of Debentures did not respond to the Conversion Offering in 1999, and the offer to convert the Debentures into the Company’s Common Stock has since expired and any contractual claims for rights pursuant to the Debentures have been time-barred by the applicable statute of limitations. Accordingly, the Company extinguished the Debentures on November 15, 2006 and any obligation owed under their terms. The Company recorded other income of $40,135 and reversed all accrued interest as a result of extinguishment.

143


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 11 STOCKHOLDERS’ EQUITY
Stock Issuances
During the year ended December 31, 2006, the Company sold 429,500 shares of its Common Stock to new stockholders for a total consideration of $809,000, less $106,132 in transaction costs.
During the year ended December 31, 2006, 186,505 shares of Series A Preferred Stock were converted into 186,505 shares of the Company’s Common Stock in accordance with the Certificate of Designation for the Series A Preferred Stock (the “Certificate of Designation”). The terms of the Certificate of Designation required the holders of the Preferred Stock to convert their shares into the Company’s Common Stock on a share for share basis on the second anniversary from the date of issuance of the Preferred Stock. The remaining shares of 96,667 shares of Preferred Stock sold under the Certificate of Designation will convert into shares of Common Stock during the 3 month period ended March 31, 2007.
The total amount of dividends declared to the holders of Preferred Stock was $35,500 during the year ended December 31, 2006.
Stock Grants and Options
At the annual meeting of stockholders of the Company on December 18, 2002, the stockholders approved the adoption of the MedSolutions, Inc. 2002 Stock Plan. The purpose of the plan is to attract and retain the best available personnel for positions of substantial responsibility, to provide additional incentive to employees, directors and consultants and to promote the success of the Company’s business. Options granted under the plan may be Incentive Stock Options or Nonstatutory Stock Options, as determined by the Board of Directors at the time of grant. On August 17, 2006, the Board of Directors approved an increase in the number of shares available for future grants and awards under the 2002 Stock Plan to 3,000,000 shares from 850,000 shares. The shareholders of the Company approved the amendment to the 2002 Stock Plan at their Annual Shareholder’s Meeting on October 19, 2006.
The option grants have a contractual life up to ten years. Options for 478,796 and 674,336 shares were granted to directors and employees during 2006 and 2005, respectively. During the year ended December 31, 2006 and 2005, respectively, the Company granted its directors 134,223 and 81,208, respectively, stock options in lieu of payment of director fees. As of December 31, 2006, all stock options outstanding are fully vested. The amount of stock options available for future issuance is 1,671,204 shares as of December 31, 2006.

144


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 11 STOCKHOLDERS’ EQUITY (continued)
Stock Grants and Options (continued)
     A summary of activity involving options on the Company’s common stock follows:
                         
            Weighted        
            Average     Aggregate  
    Number of     Exercise     Intrinsic  
    Options     Price     Value  
Balance outstanding at December 31, 2004
    268,118     $ 1.00          
 
Granted
    674,336     $ 0.82          
Exercised
                   
Cancelled/Expired
    92,454     $ 1.00          
 
                     
Balance outstanding at December 31, 2005
    850,000     $ 0.82     $ 0  
 
                     
 
Granted
    478,796     $ 0.75          
Exercised
                   
Cancelled/Expired
                   
 
                   
Balance outstanding at December 31, 2006
    1,328,796     $ 0.80     $ 106,303  
 
                 
 
                       
Number of options exercisable at December 31, 2006
    1,328,796     $ 0.80     $ 106,303  
 
                 
Stock options outstanding at December 31, 2006 for each of the following classes of options, by exercise price, are summarized as follows:
                         
            WEIGHTED-AVERAGE    
    NUMBER OF   REMAINING   NUMBER OF OPTIONS
EXERCISE PRICE   OPTIONS   CONTRACTUAL LIFE   CURRENTLY EXERCISABLE
 
$1.00
    80,164     7.00 years     80,164  
$1.00
    95,500     8.00 years     95,500  
$1.00
    79,173     8.50 years     79,173  
$0.75
    289,736     8.51 years     289,736  
$0.75
    305,427     9.00 years     305,427  
$0.75
    478,796     9.80 years     478,796  

145


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 12 WASTE MANAGEMENT FACILITY AGREEMENT
On June 8, 2006, the operating agreement between the Company and the University of Texas Medical Branch (“UTMB”) expired. The operating agreement allowed the Company to manage the UTMB incineration facility and process their waste for a fee as well as provided a facility for the Company to treat waste generated from EMSI South Texas and Louisiana customers in return for a fee paid to UTMB. Currently, the Company is taking generated waste from South Texas and Louisiana to other third party facilities in South Texas and Northern Louisiana and to its Garland facility.
NOTE 13 COMMITMENTS AND CONTINGENCIES
Risks and Concentrations
Financial instruments, which potentially subject the Company to concentrations of credit risk, are primarily cash and cash equivalents, trade accounts receivable and related party notes.
     The Company carries $10 million of liability insurance (including umbrella coverage), and $5 million of aggregate pollution and legal liability insurance ($1 million per incident), which the Company considers sufficient to meet regulatory and customer requirements and to protect its employees, assets and operations. The Company’s pollution liability insurance excludes liabilities under CERCLA. There can be no assurance that the Company will not face claims under CERCLA or similar state laws resulting in substantial liability for which the Company is uninsured and which could have a material adverse effect on its business.
Lease Obligations
Effective February 10, 2005, the Company extended and renewed its lease at its corporate headquarters in Dallas, Texas. The Company has leases for its corporate office and other facilities for terms which expire through December 2012. Minimum annual rentals under the leases are as follows:
         
Years Ended      
December 31,   Amount  
2007
  $ 97,547  
2008
    99,491  
2009
    99,491  
2010
    103,118  
2011
    104,384  
Thereafter
    43,493  
 
     
 
  $ 547,524  
 
     

146


Table of Contents

MEDSOLUTIONS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
FOR THE YEARS ENDED DECEMBER 31, 2006 AND 2005
NOTE 13 COMMITMENTS AND CONTINGENCIES (continued)
During the year ended December 31, 2002, the Company entered into an operating lease agreement for the use of new vehicles to use in the transportation segment of its business. The monthly lease payments range from $713 to $1,237 and the lease periods range from 60 to 84 months for the vehicles. In addition, the Company pays a per-mile maintenance fee of $0.065 to $0.070 for the use of the vehicles. The following table shows the future minimum operating lease payments that are due under the contracts:
         
Years Ended      
December 31,   Amount  
2007