Common Contracts

Patient Membership Agreement

Patient Membership Agreement • October 11th, 2021 • Georgia

• Contract Type
  Patient Membership Agreement
• Filed
  October 11th, 2021
• Jurisdiction
  Georgia

● This agreement is made effective on the date set forth on the signature page and is an agreement between, Harris Internal Medicine, LLC, and the patient identified on the signature page (“you and/or member and/or patient”).