Common Contracts
1 similar Conditional Agreement contracts
CONDITIONAL AGREEMENTConditional Agreement • April 7th, 2022
RELEASE OF INFORMATION: THE UNDERSIGNED AUTHORIZE THE OFFICE OF HIGHLAND FAMILY PRACTICE TO RELEASE PART OR ALL OF THE PATIENT’S RECORDS TO ANY PERSON OR ORGANIZATION LIABLE FOR THE BILL (CHARGES). THE UNDERSIGNED AUTHORIZE THE OFFICE OF HIGHLAND FAMILY PRACTICE TO SEND ELECTRONIC CONFIRMATIONS.
