S uccessors and Assigns. The parties agree that this agreement shall be fully binding on their heirs, successors, and assigns. The parties hereto, intending to be legally bound by signing this agreement below, have caused this agreement to be executed on the date written below. V irginia Xxxxx, PhD Name of Psychologist (printed) Name of Beneficiary (printed) or his/her Legal Representative Signature of Psychologist Signature of Beneficiary or his/her Legal Representative
Appears in 2 contracts
Samples: Medicare Private Contract, Medicare Private Contract
S uccessors and Assigns. The parties agree that this agreement shall be fully binding on their heirs, successors, and assigns. The parties hereto, intending to be legally bound by signing this agreement below, have caused this agreement to be executed on the date written below. V irginia Xxxxx, PhD Name of Psychologist (printed) Name of Beneficiary (printed) or his/her Legal Representative Signature of Psychologist Signature of Beneficiary or his/her Legal RepresentativeRepresentative Date of Signature Date of Signature
Appears in 1 contract
Samples: Medicare Private Contract
S uccessors and Assigns. The parties agree that this agreement shall be fully binding on their heirs, successors, and assigns. The parties hereto, intending to be legally bound by signing this agreement below, have caused this agreement to be executed on the date written below. V irginia Xxxxx, PhD Name of Psychologist (printed) Name of Beneficiary (printed) or his/her Legal Representative Signature of Psychologist Signature of Beneficiary or his/her Legal RepresentativeRepresentative Date of Signature Date of Signature
Appears in 1 contract
Samples: Medicare Private Contract