Common Contracts
1 similar Treatment and Financial Agreement contracts
Treatment and Financial AgreementTreatment and Financial Agreement • February 16th, 2023
Treatment: HUPTI accepts the patient named below for proton therapy treatment. The undersigned hereby consents to HUPTI providing and administering all services and supplies ordered by the patient’s attending physicians, and to the performance of all proton therapy procedures they deem advisable. I acknowledge that all medical treatment involves some risks and that no guarantee can be given regarding the outcome.
