Common Contracts
2 similar Informed Consent contracts
Western Carolina Medical Society Foundation Healthy Healer ProgramInformed Consent • May 2nd, 2017
The purpose of this document is to inform you of the terms of participation in Western Carolina Medical Society’s Healthy Healer Program. Please read it carefully and ask your therapist/coach if you have any questions. Return this form to your therapist/coach once completed. This document will be kept confidential and sent directly to a 3rd party law firm selected by WCMS for safekeeping. This document will not be shared with WCMS or any other party without your permission, unless required for legal purposes. This agreement holds only for self-pay patients. If you use insurance for any services you are not participating in the Healthy Healer Program and will not qualify for discounted services.
Western Carolina Medical Society Foundation Healthy Healer ProgramInformed Consent • May 2nd, 2017
The purpose of this document is to inform you of the terms of participation in Western Carolina Medical Society’s Healthy Healer Program. Please read it carefully and ask your therapist/coach if you have any questions. Return this form to your therapist/coach once completed. This document will be kept confidential and sent directly to a 3rd party law firm selected by WCMS for safekeeping. This document will not be shared with WCMS or any other party without your permission, unless required for legal purposes. This agreement holds only for self-pay patients. If you use insurance for any services you are not participating in the Healthy Healer Program and will not qualify for discounted services.
