Common Contracts
1 similar Hospital Agreement contracts
HOSPITAL AGREEMENTHospital Agreement • June 18th, 2013
License Number Licensee Site Address Signature of Program Sponsor Date Printed Name California Code of Regulations, Title 9, Division 4, Chapter 4, Subchapter 3,Section 10340 Each program sponsor that is not physically located in a hospital must enter into an agreement with a hospital official to ensure that general medical care for opiate addiction related problems is provided to patients of narcotic treatment programs who require such care. Neither the program sponsor nor the hospital is required to assume financial responsibility for medical care as a result of this agreement. Hospital Address Contact Person Telephone Number As an authorized representative for the hospital, I agree to the terms as stated in this agreement. Signature Date Printed Name Title
