GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • November 12th, 2015
Contract Type FiledNovember 12th, 2015Aesthetic Facial Body Plastic Surgery, PLLC’s ("AFBPS"), by and through Dr. Phillip Young, agree to provide treatment to: (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFBPS may require from time to time.
GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • November 12th, 2015
Contract Type FiledNovember 12th, 2015Aesthetic Facial Body Plastic Surgery, PLLC’s ("AFBPS"), by and through Dr. Phillip Young, agree to provide treatment to: (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFBPS may require from time to time.
GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • November 12th, 2015
Contract Type FiledNovember 12th, 2015Aesthetic Facial Body Plastic Surgery, PLLC’s ("AFBPS"), by and through Dr. Phillip Young, agree to provide treatment to: (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFBPS may require from time to time.