Doctor-Patient Service AgreementDoctor-Patient Service Agreement • July 7th, 2020 • New Hampshire
Contract Type FiledJuly 7th, 2020 JurisdictionThis Agreement is entered into by and between Active Choice Healthcare (“ACH”), Eric Kropp MD (“Dr. Kropp”), and _, Date of Birth: _ (“Patient”). ACH is a Direct Primary Care medical practice. Dr. Kropp is the owner and primary physician of ACH. Dr. Kropp practices Family Medicine and delivers care on behalf of ACH at 13 Chenell Drive, Suite 2, Concord, NH, 03301.
Doctor-Patient Service AgreementDoctor-Patient Service Agreement • May 2nd, 2024
Contract Type FiledMay 2nd, 2024This Agreement is entered into by and between Active Choice Healthcare (“ACH”), Eric Kropp MD (“Dr. Kropp”), and , Date of Birth: (“Patient”). ACH is a Direct Primary Care medical practice. Dr. Kropp is the owner and primary physician of ACH. Dr. Kropp practices Family Medicine and delivers care on behalf of ACH at 13 Chenell Drive, Suite 2, Concord, NH, 03301.