Patient Non-Covered Services Agreement Sample Contracts

The Doctor’s Office at 83 S. Main Patient Non-covered Services Agreement

Patient Non-Covered Services Agreement • January 30th, 2022 • Tennessee

• Contract Type
  Patient Non-Covered Services Agreement
• Filed
  January 30th, 2022
• Jurisdiction
  Tennessee

This is an agreement between Leah B. Gilliam, MD, PC, a Tennessee Professional Corporation, located at 83 S. Main St, Lexington, TN 38351 (referred to hereafter as LBG) and you (Patient).