NEW CLIENT AGREEMENTNew Client Agreement • March 11th, 2021
* You may rest assured that your email address will never be shared with any third party. It will only be used by FUNNYBONES to notify you of special events and promotions – and to contact you, should the need arise, while your dog is in our care.
NEW CLIENT AGREEMENTNew Client Agreement • December 28th, 2021
NEW CLIENT AGREEMENTNew Client Agreement • June 27th, 2016 • Pennsylvania
This private contract for Medicare covered services (this “Agreement”) is made as of the date on the signature page of this Agreement (“Effective Date”) between you and Lancaster General Medical Group, doing business as Novara (“Novara”).
NEW CLIENT AGREEMENTNew Client Agreement • August 22nd, 2010
Welcome to my practice. This document (the Agreement) contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which is attached to this Agreement, explains HIPAA and its application to your personal health information in greater detail, and my practice is in general accordance with HIPAA policies. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents a
New Client AgreementNew Client Agreement • April 17th, 2019 • Indiana
This agreement is established on {$_datetime|date_format:'%D'} between Vortex Web Solutions LLC (referred to hereinafter as "Company") and {$organization} (referred to hereinafter as "Client") .
NEW CLIENT AGREEMENTNew Client Agreement • April 30th, 2006
* You may rest assured that your email address will never be shared with any third party. It will only be used by FUNNYBONES to notify you of special events and promotions.
