Common Contracts

1 similar Patient Conditions of Treatment and Informed Consent to Treat contracts

Maryann Simpson, NP.
Patient Conditions of Treatment and Informed Consent to Treat • July 6th, 2017

This document is a binding agreement (the “Agreement”) between Maryann Simpson, NP (NP defined as Nurse Practitioner) and the individual patient whose name and signature appears below (“You” “Your”). In consideration of the health care services which may be provided to you by Maryann Simpson, NP at the present and at all times in the future. You agree as follows (your agreement indicated by placing your initials on the lines following each section and by signing in the space provided):

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