Common Contracts
2 similar Patient Agreement contracts
PATIENT AGREEMENT FORMPatient Agreement • March 25th, 2021 • Florida
This is an Agreement between My Doc, L.L.C., a membership based Internal Medicine practice located at 721 South Orange Blossom Trail, Apopka, Florida 32703, and You (Patient) to receive medical services from a team of healthcare providers acting in their capacity as agents of My Doc, L.L.C.
PATIENT AGREEMENT FORMPatient Agreement • April 24th, 2020 • Florida
This is an Agreement between My Doc, L.L.C., a membership based Internal Medicine practice located at 721 South Orange Blossom Trail, Apopka, Florida 32703, and You (Patient) to receive medical services from a team of healthcare providers acting in their capacity as agents of My Doc, L.L.C.
