Common Contracts
1 similar Patient Agreement contracts
Patient AgreementPatient Agreement • September 30th, 2021
This Agreement is entered into by and between Impact Family Wellness (“IFW”), a Texas Professional Association, Monica McKitterick, APRN, Joanna Meley, APRN, & Jessica Katie Hamilton, APRN, FNP-C (“providers”) and the undersigned patient (“member”). IFW is a Direct Primary Care medical practice. The providers of IFW offer primary and urgent care services to the members of IFW. The providers deliver care on behalf of IFW at 507 Denali Pass, Suite 605, Cedar Park, TX. 78613 , and also provide care via electronic communication and phone. In exchange for the fees set out in this Agreement, the providers and IFW agree to provide the member the services set forth below. This agreement is entered by mutual voluntary consent.
