Surgery Center Admission and Financial Agreement Sample Contracts

SURGERY CENTER ADMISSION AND FINANCIAL AGREEMENT
Surgery Center Admission and Financial Agreement • March 20th, 2024

LEGAL RELATIONSHIP BETWEEN SURGERY CENTER AND PHYSICIANS: I understand that all physicians furnishing services to the patient, including the patient’s physician, and any specialist such as an anesthesia provider, radiologist or pathologist are independent contractors with the patient and are not employees or agents of the surgery center. The patient is under the care and supervision of his/her physician, and it is the responsibility of the surgery center and its staff to carry out instructions of the physician. It is the responsibility of the patient’s physician to obtain the patient’s informed consent, to medical or surgical treatment or procedures. Any questions concerning the nature or results of any examination or treatment should be directed to the patient’s physician and not to the surgery center employees.

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SURGERY CENTER ADMISSION AND FINANCIAL AGREEMENT
Surgery Center Admission and Financial Agreement • August 24th, 2023

LEGAL RELATIONSHIP BETWEEN SURGERY CENTER AND PHYSICIANS: I understand that all physicians furnishing services to the patient, including the patient’s physician, and any specialist such as an anesthesia provider, radiologist or pathologist are independent contractors with the patient and are not employees or agents of the surgery center. The patient is under the care and supervision of his/her physician and it is the responsibility of the surgery center and its staff to carry out instructions of the physician. It is the responsibility of the patient’s physician to obtain the patient’s informed consent, to medical or surgical treatment or procedures. Any questions concerning the nature or results of any examination or treatment should be directed to the patient’s physician and not to the surgery center employees.

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