Direct Primary Care Membership Patient Agreement Sample Contracts

DIRECT PRIMARY CARE MEMBERSHIP PATIENT AGREEMENT

Direct Primary Care Membership Patient Agreement • July 14th, 2021 • Wisconsin

• Contract Type
  Direct Primary Care Membership Patient Agreement
• Filed
  July 14th, 2021
• Jurisdiction
  Wisconsin

This is an Agreement between Anovia Health, SC (Practice), a Wisconsin S.C., located at Box 230, S. Webster Ave., Green Bay, WI 54301, your healthcare provider (Provider) in his/her capacity as an agent of the Practice, and you, (Patient).

DIRECT PRIMARY CARE MEMBERSHIP PATIENT AGREEMENT

Direct Primary Care Membership Patient Agreement • June 19th, 2020 • Wisconsin

• Contract Type
  Direct Primary Care Membership Patient Agreement
• Filed
  June 19th, 2020
• Jurisdiction
  Wisconsin

This is an Agreement between Priority Medical Partners Direct, S.C. (Practice), a Wisconsin S.C., located at 580 Shepard Street, Rhinelander, WI, 54501, your healthcare provider (Provider) in his/her capacity as an agent of the Practice, and you, (Patient).