Consent for Emergency Treatment. I authorize the University of Wisconsin – Extension - Ozaukee County and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATION.
Appears in 2 contracts
Samples: Indemnification & Liability, Indemnification Agreement
Consent for Emergency Treatment. I authorize the University of Wisconsin – Extension - Ozaukee County Wisconsin-Milwaukee and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATIONagree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Appears in 1 contract
Samples: Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment
Consent for Emergency Treatment. I authorize the University of Wisconsin – Extension - Ozaukee Xxxxxx County and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATIONagree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Appears in 1 contract
Samples: Assumption of Risk Agreement
Consent for Emergency Treatment. I authorize the University of Wisconsin – Extension - Ozaukee County Milwaukee and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATION.
Appears in 1 contract
Samples: Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment