Common Contracts

2 similar Ambulance Membership Plan Coverage Agreement contracts

AGREEMENT FOR MEMBERSHIP: This Ground Ambulance Membership Plan Coverage Agreement (“Agreement”) is entered into between Dignity Health St. Elizabeth Communi- ty Hospital, doing business as Dignity Health St. Elizabeth Community Hospital (referred to...
Ambulance Membership Plan Coverage Agreement • May 30th, 2013

By signing the Application, I agree, on behalf of myself and the residents of my household listed on the Application, to abide by the terms of Dignity Health St. Elizabeth Community Hospital’s Ambulance Membership Plan (the “Plan”), as set forth in this Agreement. Cov- erage will begin the day after Dignity Health St. Elizabeth Community Hospital receives my Application and payment, and will expire midnight on the last day of the month payment is received of the following year.

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AGREEMENT FOR MEMBERSHIP: This Ground Ambulance Membership Plan Coverage Agreement (“Agreement”) is entered into between Dignity Health St. Elizabeth Communi- ty Hospital, doing business as Dignity Health St. Elizabeth Community Hospital (referred to...
Ambulance Membership Plan Coverage Agreement • May 30th, 2013

By signing the Application, I agree, on behalf of myself and the residents of my household listed on the Application, to abide by the terms of Dignity Health St. Elizabeth Community Hospital’s Ambulance Membership Plan (the “Plan”), as set forth in this Agreement. Cov- erage will begin the day after Dignity Health St. Elizabeth Community Hospital receives my Application and payment, and will expire midnight on the last day of the month payment is received of the following year.

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