COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as described above.
Appears in 2 contracts
Samples: Therapy Agreement, Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as described abovebelow.
Appears in 1 contract
Samples: Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 25 cents per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as described above.
Appears in 1 contract
Samples: Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as described above.
Appears in 1 contract
Samples: Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 2.00 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as a described above.
Appears in 1 contract
Samples: Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 1 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or the designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as described above.
Appears in 1 contract
Samples: Therapy Agreement
COPIES OF MEDICAL RECORDS. Should you request a copy of your medical records they will be dispensed at $1.00 per page. Payment for your medical records will be due prior or upon receipt of them and can be picked up at our office. Please office please allow at least 2 weeks to prepare your records. You will also need to sign a release for medical records to be dispensed to either you or designated party, and I reserve the right to provide a summary of process notes, in lieu of the actual notes, as a described above.
Appears in 1 contract
Samples: Therapy Agreement