Direct Primary Care Patient AgreementDirect Primary Care Patient Agreement • February 6th, 2019 • Tennessee
Contract Type FiledFebruary 6th, 2019 JurisdictionThis is an Agreement between PATMOS EmergiClinic, Inc., (Practice), a Tennessee Corporation, located at 1231 Tusculum Blvd., Greeneville, TN 37745, Robert S. Berry, M.D. (Physician) in his capacity as an agent of PATMOS EmergiClinic, Inc. (whose name will change to DirectMD Greeneville), and (Patient). This Agreement is entered by mutual voluntary consent on , 20 .