Agreement DetailsResident Service Agreement • November 16th, 2020 • England and Wales
These Agreement Details, together with the attached terms and conditions (as amended from time to time in accordance with such terms and conditions) (the “Terms”), form this Resident service agreement (the “Agreement”) which governs the legal relationship, between the Company (including the Home), the Resident and any Third Party Payer (each as named below), applying to the Resident’s residence at the Home.
Attachments to Resident Service Agreement & Power of Attorney Presentation November 2018Resident Service Agreement • November 12th, 2018
This authorization for release of medical information and financial information shall also be considered a consent to the release of such information under current laws, rules, and regulations as well as under future laws, rules, and regulations, and amendments to such laws, rules, and regulation to include but not be limited to the express grant of authority provided by the Medical Information Privacy law and regulation generally referred to as HIPAA. This authorization extends to facility’s employees, agents and any other person the facility determines is reasonably necessary to have the information.
RESIDENT SERVICEResident Service Agreement • September 26th, 2022
ContractResident Service Agreement • August 30th, 2011
PO Box 300/ 3680 Hwy 411 NE, White, GA 30184 (770) 382-6655 Office • (770) 387-2345 FaxResident Service & Agreement • January 21st, 2021 • Georgia
Hickory Log has invested fifty years into serving men living with special needs. All of the men are vital members of the Hickory Log family and all of the years were well spent. As a new resident of Hickory Log, we are honored to call you family and look forward to sharing life with you for many years to come!
