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For more information visit our privacy policy.PATIENT AGREEMENTPatient Agreement • July 13th, 2020 • Florida
Contract Type FiledJuly 13th, 2020 JurisdictionThis PATIENT AGREEMENT ("Agreement") specifies the terms and conditions between Balanced Physician Care, P.A. , a Florida professional association (“BPC") located at 115 Professional Drive Suite 104, Ponte Vedra Beach, Florida and , (hereinafter "Patient"), under which Patient may participate in the Balanced Physician Care Program, effective as of (the "Effective Date"). (Patient and BPC may each be referred to as a “Party” and collectively as “Parties”).