DIRECT PRIMARY CARE MEMBERSHIP PATIENT AGREEMENTMembership Patient Agreement • July 14th, 2021 • 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 AGREEMENTMembership Patient Agreement • June 19th, 2020 • 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).
