Common Contracts
1 similar Agreement contracts
CHIROPRACTIC CARE OF MINNESOTA, INC. PARTICIPATING PROVIDER AGREEMENTAgreement • December 3rd, 2010
The undersigned chiropractor, whose licensee(s) to practice chiropractic is(are) in good standing, and all license numbers are listed below, hereby agrees to all terms, conditions and provisions of the attached CHIROPRACTIC CARE OF MINNESOTA, INC. PARTICIPATING PROVIDER AGREEMENT. By checking the box below, the undersigned chiropractor elects to participate in the HealthPartners Worker’s Compensation Addendum to this Agreement. The undersigned chiropractor further agrees and understands that this agreement shall not be given effect until it has been countersigned by the appropriate officer of Chiropractic Care of Minnesota, Inc.
