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 (for example, emergency treatment), patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for exampleincluding, but not limited to, emergency treatment), ) patient should initial here. . below: (Effective as of the date of first professional medical services. ) Patient’s or Patient Representative’s Initials If any provision of this Arbitration Agreement arbitration agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copyarbitration agreement.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If the patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature belowon reverse, I acknowledge that I have received a copy.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If a patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Effective as of the date of first professional services. If , if any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this the Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. here . Effective as of the date of first professional services. If any provision of this Arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.

Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), patient should initial here. . Effective as of the date of first professional services. If any provision of this Arbitration arbitration Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and shall not be affected by the invalidity of any other provision. I understand that I have the right to receive a copy of this Arbitration Agreement. By my signature below, I acknowledge that I have received a copy.