Common Contracts
1 similar Patient Services Agreement contracts
LIPP, CARLSON, WITUCKI and ASSOCIATES, LTDPatient Services Agreement • March 19th, 2020
YOUR SIGNATURE BELOW INDICATES YOU HAVE READ THE INFORMATION IN THE PATIENT SERVICES AGREEMENT (Revised 02/21/2019) AND AGREE TO ABIDE BY ITS TERMS DURING THE PROFESSIONAL RELATIONSHIP YOU HAVE WITH LIPP, CARLSON, WITUCKI and ASSOCIATES, ITS STAFF, AND ITS PROVIDERS. YOUR SIGNATURE ALSO INDICATES YOU WERE OFFERED A COPY OF THIS AGREEMENT FOR YOUR OWN RECORDS.
