CONCIERGE PRACTICE PATIENT AGREEMENTConcierge Practice Patient Agreement • December 4th, 2020 • Georgia
Contract Type FiledDecember 4th, 2020 Jurisdictionlocated at 410 Peachtree Parkway, Ste 4226 Cumming, GA 30041(Practice), Brent Carroll D.O, (Physician) in his capacity as an agent of Carroll Total Healthcare, and (Patient(s)).