PHYSICIANPATIENT AGREEMENTPhysician-Patient Agreement • September 18th, 2020
This agreement serves to inform Dr. Imig’s patients regarding office policies, physician policies, and the physicianpatient relationship. Please read this agreement in its entirety an sign where indicated to acknowledge your understanding of this agreement and to abide by the policies contained therein.
KEVIN E CARLSON MD, PA PHYSICIAN/PATIENT AGREEMENTPhysician/Patient Agreement • October 9th, 2017
I, the undersigned, wish to receive my primary care medical services from Kevin E Carlson MD, PA (the “Practice”) and Kevin Carlson MD. I understand that these medical services are offered subject to the following terms and conditions:
PHYSICIAN-PATIENT AGREEMENTPhysician-Patient Agreement • September 8th, 2021
This agreement serves to inform Dr. Imig’s patients regarding office policies, physician policies, and the physician-patient relationship. Please read this agreement in its entirety and sign where indicated to
ContractPhysician/Patient Agreement • December 15th, 2011
I, the undersigned, wish to receive my primary care medical services from Amy H. Gordon, M.D., LLC (the “Practice”) and Amy H. Gordon, M.D. (“Dr. Gordon”). I understand that these medical services are offered subject to the following terms and conditions:
