Common Contracts
1 similar Client Agreement for Services contracts
CLIENT AGREEMENT FOR SERVICESClient Agreement for Services • March 20th, 2019
Our Pharmacy has been chosen to provide pharmacy services at _Assisted Living Facility, we will be working with your facility in providing and managing your medications while staying in the facility. PharmcareUSA pharmacies kindly ask that you sign this form to ensure that we remain in compliance with Medicare and all other governing agencies. By execution of this Agreement, I consent and/or elect PharmcareUSA as my primary pharmacy to provide my pharmacy services and understand that PharmcareUSA accepts Medicare and Medicaid business.
