Common Contracts

PATIENT AGREEMENT‌

Patient Agreement • January 21st, 2022 • Florida

• Contract Type
  Patient Agreement
• Filed
  January 21st, 2022
• Jurisdiction
  Florida

Thisagreement(this“Agreement”) between MEGANWEIGEL, DNP, L.L.C. d/b/a First Coast Integrative Medicine, a Florida professional limited liability corporation (“FCIM”), located at 14215 Spartina Court, Ste 200, Jacksonville, FL, 32224 and you, (the person signing below, referred to as “You”) is effective as of the date of Your signature.

PATIENT AGREEMENT

Patient Agreement • October 3rd, 2020 • Florida

• Contract Type
  Patient Agreement
• Filed
  October 3rd, 2020
• Jurisdiction
  Florida

Thisagreement(this“Agreement”) between MEGANWEIGEL, DNP, L.L.C. d/b/a First Coast Integrative Medicine, a Florida professional limited liability corporation (“FCIM”), located at 14215 Spartina Court, Ste 200, Jacksonville, FL, 32224 and you, (the person signing below, referred to as “You”) is effective as of the date of Your signature.

PATIENT AGREEMENT

Patient Agreement • December 31st, 2019 • Florida

• Contract Type
  Patient Agreement
• Filed
  December 31st, 2019
• Jurisdiction
  Florida

This agreement (this “Agreement”) between MEGAN WEIGEL, DNP, L.L.C. d/b/a First Coast Integrative Medicine, a Florida professional limited liability corporation (“FCIM”), located at 14215 Spartina Court, Ste 200, Jacksonville, FL, 32224 and you, (the person signing below, referred to as “You”) is effective as of the date of Your signature.