Assignment of Personal Injury Protection Benefits and Lien Agreement Sample Contracts

Assignment of Personal Injury Protection Benefits and Lien Agreement
Assignment of Personal Injury Protection Benefits and Lien Agreement • June 4th, 2021

I, , in order to provide and facilitate the ability of We Care Physical Therapy, LLC (“Provider”) to collect their charges for the services provided to me after my automobile accident (“Charges”)1 directly from the Payor/Insurance Company, agree as follows:

Sample 1
AutoNDA by SimpleDocs
Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!