Common Contracts
1 similar Medicare Opt Out Agreement contracts
Appendix 2 Medicare Opt Out AgreementMedicare Opt Out Agreement • February 3rd, 2021
This contract is entered into, by and between Jan Hester MD PC (herein after called the “Physician”), whose principal medical office is located at 1120 E Elizabeth St, Building G, Suite 1 Fort Collins CO 80524 and (hereinafter called the “Beneficiary”), who resides at
