Common Contracts

CHILD AND ADOESCENT PATIENT REGISTRATION AGREEMENT

Patient Registration Agreement • October 6th, 2021

• Contract Type
  Patient Registration Agreement
• Filed
  October 6th, 2021

• I/We understand that the initial meeting is for the purpose of evaluation and to determine if a working relationship with Dr. Segal can be established.

CHILD AND ADOLESCENT PATIENT REGISTRATION AGREEMENT

Patient Registration Agreement • March 18th, 2020

• Contract Type
  Patient Registration Agreement
• Filed
  March 18th, 2020

• I/We understand that the initial meeting is for the purpose of evaluation and to determine if a working relationship with Dr. Segal can be established.