Concierge Urgent Care AgreementConcierge Urgent Care Agreement • December 4th, 2020
_, 20_, and effective as of the day of � 20_, between you the parent of and Lawrence Chapel Pediatrics, PLLC (the "Practice") under which the Practice will make certain enhanced urgent care services available to you which are not otherwise provided to other patients by this Practice. By voluntarily entering into this Agreement and remitting the annual retainer fee as set forth below, you are participating in the Practice's Concierge Urgent Care services for a period of twelve (12) months beginning on the effective date payable on a quarterly basis or annually.
