COVID 19 Onsite Patient Care AgreementPatient Care Agreement • July 4th, 2020
Boston Sensory Solutions is dedicated to the health and safety of its staff, patients, and families. In order to effectively work together in person at this time of Covid-19 prevalence, patients and families agree to the following precautions. Please initial each precaution as your indication of agreement to follow these precautions. This is in addition to all previously signed consents.
PATIENT CARE AGREEMENTPatient Care Agreement • October 19th, 2012
I, , in exchange for receiving treatment and care from the Miami Institute for Joint Reconstruction, and its affiliated physicians including , M.D. (which includes all employees of the Miami Institute for Joint Reconstruction and/or of my physician), hereby acknowledge and accept the following terms (please place your initials by each paragraph):
PATIENT CARE AGREEMENTPatient Care Agreement • November 11th, 2020 • Maine
This is an agreement entered into on , 20 , by and between Esti Grossberger, NP In Family Health, PLLC (DBA Silver Lining Care), located at 55 Old Turnpike Road, Suite 405, Nanuet, NY 10954 (Esti Grossberger, NP In Family Health, PLLC) and
PATIENT CARE AGREEMENTPatient Care Agreement • January 29th, 2022 • Maine
This is an agreement entered into on , 20 , by and between Phoenix Direct Care, PLLC, located at 14 Sweden St Suite 203, Caribou, ME 04736 (Phoenix Direct Care, PLLC) and
Patient Care AgreementPatient Care Agreement • July 16th, 2021
Our goal is to provide and maintain a good physician-patient relationship. Letting you know in advance of our office policy allows for a good flow of communication and enables us to achieve our goal. Please read this carefully and if you have any questions, please do not hesitate to ask a member of our staff.
COVID 19 Onsite Patient Care AgreementPatient Care Agreement • August 9th, 2020
Boston Sensory Solutions is dedicated to the health and safety of its staff, patients, and families. In order to effectively work together in person at this time of Covid-19 prevalence, patients and families agree to the following precautions. Please initial each precaution as your indication of agreement to follow these precautions. This is in addition to all previously signed consents.
PATIENT CARE AGREEMENTPatient Care Agreement • September 26th, 2012
I, , in exchange for receiving treatment and care from the Miami Institute for Joint Reconstruction, and its affiliated physicians including , M.D. (which includes all employees of the Miami Institute for Joint Reconstruction and/or of my physician), hereby acknowledge and accept the following terms (please place your initials by each paragraph):
Patient Care AgreementPatient Care Agreement • June 2nd, 2024
