THIS PHYSICIAN PRACTICE LIEN AGREEMENT (the “Agreement”) is hereby entered into by and among:Physician Practice Lien Agreement • September 19th, 2018
Contract Type FiledSeptember 19th, 2018WHEREAS, Patient was injured in an accident or incident and is seeking medical/diagnostic care from Provider for his/her injuries; and
THIS PHYSICIAN PRACTICE LIEN AGREEMENT (the “Agreement”) is hereby entered into by and among:Physician Practice Lien Agreement • November 14th, 2017
Contract Type FiledNovember 14th, 2017WHEREAS, Patient was injured in an accident or incident and is seeking medical/diagnostic care from Provider for his/her injuries; and