Common Contracts
4 similar Patient Agreement contracts
UNIVERSITY HEALTH CENTER PATIENT AGREEMENTPatient Agreement • June 22nd, 2023
I, , hereby authorize University Health Center (UHC), their employees and consultants to perform diagnostic and treatment procedures which, in their judgement, may become necessary while I am a patient 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 • March 31st, 2023
I, , hereby authorize University Health Center (UHC), their employees and consultants to perform diagnostic and treatment procedures which, in their judgement, may become necessary while I am a patient 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 • March 7th, 2022
I, , hereby authorize University Health Center (UHC), their employees and consultants to perform diagnostic and treatment procedures which, in their judgement, may become necessary while I am a student 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 • June 28th, 2021
I, , hereby authorize University Health Center (UHC), their employees and consultants to perform diagnostic and treatment procedures which, in their judgement, may become necessary while I am a student 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.
