Common Contracts

PATIENT AGREEMENT

Patient Agreement • August 17th, 2020 • Indiana

• Contract Type
  Patient Agreement
• Filed
  August 17th, 2020
• Jurisdiction
  Indiana

The Practice, located at 250 North Main Street, Suite 6D Crown Point, Indiana 46307, provides ongoing primary care services to its patients/members in a direct primary care practice model (DPC). In exchange for certain periodic fees the Practice agrees to provide the Patient with certain Services under the terms and conditions contained in this Agreement.