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FORM 8-A
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
HEALTHSOURCE, INC.
(Exact name of registrant as specified in its charter)
New Hampshire 02-0387748
(State of incorporation or (I.R.S. Employer Identification
organization) No.)
Two College Park Drive, Hooksett, NH 03105
(Address of principal executive offices) (Zip Code)
Securities to be registered pursuant to Section 12(b) of the Act:
Title of each class Name of each exchange on which
to be so registered each class is to be registered
5% Convertible Subordinated New York Stock Exchange
Notes Due 2003
If this Form relates to the registration of a class of debt securities and
is effective upon filing pursuant to General Instruction A.(c)(1), please check
the following box. [__]
If this Form relates to the registration of a class of debt securities and
is to become effective simultaneously with the effectiveness of a concurrent
registration statement under the Securities Act of 1933 pursuant to General
Instruction A.(c)(2), please check the following box. [__]
Securities to be registered pursuant to Section 12(g) of the Act:
N/A
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(Title of class)
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INFORMATION REQUIRED IN REGISTRATION STATEMENT
Item 1. Description of Registrant's Securities to be Registered.
The description of the Healthsource, Inc. (the "Company") 5%
Convertible Subordinated Notes Due 2003 set forth in the Company's Form S-3
Registration Statement, No. 333-5223, filed on June 5, 1996, is hereby
incorporated by reference.
Item 2. Exhibits
1. Indenture dated as of March 6, 1996 by and between Healthsource, Inc.
and The Bank of New York as Trustee and the form of First Supplemental
Indenture dated as of June 3, 1996 (filed as Exhibit 4.1 to the
Company's Form S-3 Registration Statement, No. 333-5223, filed on June
5, 1996)
2. Note Resale Registration Rights Agreement dated as of March 6, 1996 by
and between Healthsource, Inc. and Bear, Stearns & Co., Inc. for itself
and on behalf of the Initial Purchasers named therein (filed as
Exhibit 4.2 to the Company's Form S-3 Registration Statement, No.
333-5223, filed on June 5, 1996)
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SIGNATURE
Pursuant to the requirements of Section 12 of the Securities Exchange
Act of 1934, Healthsource, Inc. has duly caused this Registration Statement to
be signed on its behalf by the undersigned, thereto duly authorized.
HEALTHSOURCE, INC.
Dated: June 25, 1996 By: /s/ Norman C. Payson, M.D.
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Name: Norman C. Payson, M.D.
Title: President and Chief Executive
Officer
