Financial and Care Consent AgreementFinancial and Care Consent Agreement • March 3rd, 2022
Consent to Treatment. I hereby consent and authorize The Dermatology Center at Ladera and its Affiliated Providers to perform medical care, diagnostic tests, surgical care, and other therapeutic measures as indicated for my health. If I will not comply with the medical program of care provided or recommended, I understand that thereupon I relieve my physician(s), healthcare provider(s), medical staff, and the company, of all responsibility resulting from my action.
