Common use of Retroactive Effect Clause in Contracts

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:

Appears in 58 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

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Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) ), patient should initial below:here. . Effective as of the date of first professional services.

Appears in 24 contracts

Samples: Arbitration Agreement, Arbitration Agreement, Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here. . Effective as the date of first professional services.

Appears in 12 contracts

Samples: Arbitration Agreement, Arbitration Agreement, Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:.

Appears in 7 contracts

Samples: Therapist Patient Arbitration Agreement, Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:.

Appears in 3 contracts

Samples: Arbitration Agreement, Arbitration Agreement, Health Care Provider Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement Agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:;

Appears in 3 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If patient Patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:effective as of the date of first medical services.

Appears in 3 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here. . Effective as of the date of first professional services.

Appears in 3 contracts

Samples: Arbitration Agreement, Arbitration Agreement, Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example), emergency treatment) patient should initial below:here _. Effective as the date of first professional services.

Appears in 3 contracts

Samples: Arbitration Agreement, Arbitration Agreement, Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:here: . This agreement is thus effective as of the date of first medical services..

Appears in 2 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here . Effective as the date of first professional services.

Appears in 2 contracts

Samples: Arbitration Agreement, California Arbitration Agreement

Retroactive Effect. If patient Patient intends this agreement Agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient ), Patient should initial below:the following: Effective as of the date of first medical services: [Initial Here]

Appears in 2 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If the patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:.

Appears in 2 contracts

Samples: Physician Patient Arbitration Agreement, Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below: I have read and understand the above information. Patient Signature: Date:

Appears in 2 contracts

Samples: Arbitration Agreement, Arbitration Agreement

Retroactive Effect. If the patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:

Appears in 2 contracts

Samples: Physician Patient Arbitration Agreement, Physician – Patient Arbitration Agreement

Retroactive Effect. If the patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here . Effective as the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:for example,

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here. Effective as the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If a patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here _ . Effective as the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here. __________. Effective as the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient Patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient ), Patient should initial below: Effective As of Date of First Medical Services:

Appears in 1 contract

Samples: Provider Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date dates it is signed (including, but not limited to, emergency treatment) patient should initial below:

Appears in 1 contract

Samples: Physician Patient Arbitration Agreement

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Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below: Patient’s Initials:

Appears in 1 contract

Samples: Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it if is signed (including, but not limited to, emergency treatment) patient should initial below:

Appears in 1 contract

Samples: Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, to emergency treatment) patient should initial below:.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:: Effective as of the date of first medial services

Appears in 1 contract

Samples: Dentist Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient should initial below:: Effective as of the date of first medical services Client Initials

Appears in 1 contract

Samples: Physician Client Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, emergency treatment) patient ), Patient should initial below:

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement Agreement to cover services rendered before the date it is signed (includinginc luding, but not limited to, emergency treatment) patient should initial below:;

Appears in 1 contract

Samples: Physician Patient Arbitration Agreement

Retroactive Effect. If a patient intends this agreement to cover services rendered before the date it is signed (including, but not limited to, to emergency treatmentsurgery) patient should initial below:

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, including but not limited to, emergency treatment) patient should initial below:here: Submit Form

Appears in 1 contract

Samples: Physician Patient Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here _.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If patient intends this agreement to cover services rendered before the date that it is signed (including, but not limited tofor example, emergency treatment) ), patient should initial below:here . Effective as of the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

Retroactive Effect. If a patient intends this agreement to cover services rendered before the date it is signed (including, but not limited tofor example, emergency treatment) patient should initial below:here: _____. Effective as the date of first professional services.

Appears in 1 contract

Samples: Arbitration Agreement

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