Madonna Rehabilitation Hospital ADMISSION AGREEMENT ADM 003 PFS Revised 7/2014Admission Agreement • July 23rd, 2020
Contract Type FiledJuly 23rd, 2020CONSENT FOR TREATMENT: I voluntarily consent to the medical care to be provided at Madonna Rehabilitation Hospital (“Madonna”), including medical treatment provided by my attending physician or members of Madonna’s medical staff, allied health professionals, and/or independent health care providers who provide services under contract with Madonna. I further consent to the procedures which may be performed during my hospitalization or on an outpatient basis, including routine, diagnostic and medical procedures, exams, tests and nursing services and procedures. Unless an emergency exists, I understand that no substantial treatment or procedures will be performed upon me until I have had an opportunity to discuss the proposed treatment or procedures with my attending physician or other healthcare professional. I understand that I have the right to consent or to refuse consent to any proposed procedure or therapeutic treatment. I acknowledge that many physicians on the staff of Madonna are