Common Contracts
2 similar Patient Agreement contracts
UNIVERSITY HEALTH CENTER PATIENT AGREEMENTPatient Agreement • November 29th, 2018
I, , hereby authorize University Health Center (UHC), their employees and consultant to perform diagnostic and treatment procedures which, in their judgement, may become necessary while at the University of Georgia. I understand that I will be involved and engaged in my care and treatment. I understand that UHC utilizes the services of Physician Assistants, and I have a right to consult with a physician prior to receiving a prescription drug or device order. If I require specialized and/or emergency care, I will be referred to the appropriate medical facility or professional. I understand that a person listed as my emergency contact will be notified if considered necessary by the professional staff of University of Georgia.
UNIVERSITY HEALTH CENTER PATIENT AGREEMENTPatient Agreement • January 19th, 2017
I, , hereby authorize University Health Center (UHC), their employees and consultant to perform diagnostic and treatment procedures which, in their judgement, may become necessary while at the University of Georgia. I understand that I will be involved and engaged in my care and treatment. I understand that UHC utilizes the services of Physician Assistants, and I have a right to consult with a physician prior to receiving a prescription drug or device order. If I require specialized and/or emergency care, I will be referred to the appropriate medical facility or professional. I understand that a person listed as my emergency contact will be notified if considered necessary by the professional staff of University of Georgia.
