Common Contracts

Attorney Medical Lien Agreement

Medical Lien Agreement • January 16th, 2020 • Arizona

• Contract Type
  Medical Lien Agreement
• Filed
  January 16th, 2020
• Jurisdiction
  Arizona

I, do hereby authorize SAMUEL E. CARR, D.C., P.C. to furnish you, , my attorney, with prepaid copies of medical records relevant to my injury or accident for which he/she is representing me.