Common Contracts
1 similar Patient Agreement contracts
PATIENT AGREEMENTPatient Agreement • June 26th, 2012
In order to accommodate the needs and requests of our patients, we participate in numerous managed care insurance programs. While we are pleased to be able to provide this medical service to you, the Westfield Orthopedic Group cannot be aware of all the individual requirements and limitations of each plan. Each plan has different stipulations regarding how often services may be provided and, even more importantly, where those services may be performed. With this in mind; in order to establish and maintain a physician-patient relationship with our practice, the following terms must be acknowledged by the patient or responsible party (parent, guardian, etc):
