GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • April 25th, 2014
Contract Type FiledApril 25th, 2014Aesthetic Facial Plastic Surgery, PLLC’s ("AFPS"), by and through Dr. Phillip Young, agree to provide treatment to: _ (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFPS may require from time to time.
GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • April 25th, 2014
Contract Type FiledApril 25th, 2014Aesthetic Facial Plastic Surgery, PLLC’s ("AFPS"), by and through Dr. Phillip Young, agree to provide treatment to: _ (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFPS may require from time to time.
GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • April 25th, 2014
Contract Type FiledApril 25th, 2014Aesthetic Facial Plastic Surgery, PLLC’s ("AFPS"), by and through Dr. Phillip Young, agree to provide treatment to: _ (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFPS may require from time to time.
GENERAL, HIPAA, PHOTO | VIDEO INFORMED CONSENT FORM, AND RELEASE AGREEMENTGeneral Informed Consent Form and Release Agreement • April 23rd, 2014
Contract Type FiledApril 23rd, 2014Aesthetic Facial Plastic Surgery, PLLC’s ("AFPS"), by and through Dr. Phillip Young, agree to provide treatment to: _ _ (“Patient” or “you”) [insert Patient’s name] pursuant to terms and conditions set forth under this General Informed Consent Form and Release Agreement (the “Agreement”) and such other consent or release AFPS may require from time to time.