INFORMED CONSENT FOR MEDICAL TREATMENT AND PROCEDURESInformed Consent for Medical Treatment and Procedures • March 3rd, 2016 • Utah
This document is a binding agreement (the “Agreement”) between Utah Natural Medicine (“the Doctor” “UNM”) and the individual whose name and signature appears below (“I” “the Patient”) or the legal guardian thereof. In consideration of the health care services provided to the Patient by Utah Natural Medicine at the present and at all times in the future, I agree as follows (agreement is indicated by placing Patient initials on the lines following each section and by signing in the space provided at the bottom of the page):
UTAH NATURAL MEDICINEInformed Consent for Medical Treatment and Procedures • May 7th, 2007
This document is a binding agreement (the “Agreement”) between Utah Natural Medicine (“the Doctor” “UNM”) and the individual whose name and signature appears below (“I” “the Patient”) or the legal guardian thereof. In consideration of the health care services provided to the Patient by Utah Natural Medicine at the present and at all times in the future, I agree as follows (agreement is indicated by placing Patient initials on the lines following each section and by signing in the space provided at the bottom of the page):
