Common Contracts
1 similar General Consent and Financial Agreement contracts
TERMS AND CONDITONS OF SERVICE: GENERAL CONSENT AND FINANCIAL AGREEMENTGeneral Consent and Financial Agreement • March 20th, 2020
Washington Regional – Who we are; Purpose of this Agreement. Thank you for seeking medical care from Washington Regional Medical System, an integrated health system made up of various entities, including (but not necessarily limited to) the general hospital known as Washington Regional Medical Center (“WRMC”) and each of the respective hospital outpatient departments, specialty providers, and physician clinics that are specifically identified in the Washington Regional Notice of Privacy Practices, which all will be collectively referred to herein as “Washington Regional.” This Consent to Medical Care Agreement authorizes Washington Regional to provide you medical care, share your health information and seek payment for the services provided. In this document, “Patient” means the person receiving treatment. “Patient Representative” means any person acting on behalf of the Patient and signing as the Patient’s lawful representative. Use of the word “I”, “you”, “your” or “me” may in contex
