Common Contracts
1 similar Financial Agreement and Hipaa Consent contracts
FINANCIAL AGREEMENT AND HIPAA CONSENTFinancial Agreement and Hipaa Consent • December 12th, 2019
AUTHORIZATION FOR PATIENT CARE: The undersigned patient and/or representative (“Undersigned”) hereby grants permission to the employees of Trinity Medical, WNY to render routine patient care, and to carry out the orders of the patient’s physician, consultants, associates, and assistants of the Undersigned’s choice.
