FEE FOR SERVICE MEDICAL SERVICES AGREEMENT (with provision for subcontractors) Date: <<Name of Health Service Provider>>Fee for Service Medical Services Agreement • July 26th, 2023 • Western Australia
Contract Type FiledJuly 26th, 2023 JurisdictionI, the Contractor, apply to subcontract the Medical Practitioner named above, the performance of Medical Services at the Hospital(s) as set out above in Part 1.2, pursuant to the terms and conditions of the Medical Services Agreement, and Part 4 of this application. I declare that, to the best of my knowledge and belief, all the information provided is true and correct. 34