Common Contracts
2 similar Treat and Financial Agreement contracts
CONSENT TO TREAT AND FINANCIAL AGREEMENTTreat and Financial Agreement • December 22nd, 2022
Consent to Treat. You, for yourself, or as a personal representative of the patient, voluntarily consent to all medical treatment and health care-related services that the caregivers at our Clinic consider to be necessary for the patient. You understand that caregivers include physicians, technicians, nurses, and other qualified personnel, which may also include appropriately supervised students and residents, who shall perform services and procedures as may be necessary in accordance with the judgment of the attending medical provider(s).
CONSENT TO TREAT AND FINANCIAL AGREEMENTTreat and Financial Agreement • December 22nd, 2022
Consent to Treat. You, for yourself, or as a personal representative of the patient, voluntarily consent to all medical treatment and health care-related services that the caregivers at our Clinic consider to be necessary for the patient. You understand that caregivers include physicians, technicians, nurses, and other qualified personnel, which may also include appropriately supervised students and residents, who shall perform services and procedures as may be necessary in accordance with the judgment of the attending medical provider(s). These services may include diagnostic, therapeutic, imaging, and laboratory services, including HIV testing. If you want any HIV testing to be performed anonymously, you will tell the caregiver. You understand that the patient’s medical information may be shared with other providers who are involved in the patient’s care and treatment, and you consent to such disclosure. The patient’s lab samples may be used to perform routine quality assurance testi
