CONSENT TO TREAT AND FINANCIAL AGREEMENTTreat and Financial Agreement • December 22nd, 2022
Consent to Treat. You, for yourself, or as a personal representative of the patient, voluntarily consent to all medical treatment and health care-related services that the caregivers at our Clinic consider to be necessary for the patient. You understand that caregivers include physicians, technicians, nurses, and other qualified personnel, which may also include appropriately supervised students and residents, who shall perform services and procedures as may be necessary in accordance with the judgment of the attending medical provider(s).
CONSENT TO TREAT AND FINANCIAL AGREEMENTTreat and Financial Agreement • January 18th, 2023
Thank you for allowing Balboa Nephrology Medical Group (BNMG) to serve you. BNMG Providers include physicians, nurse practitioners, physician assistants, and other clinicians, who are either employed or otherwise engaged by BNMG to provide professional services to our patients. By signing this Consent to Treat and Financial Agreement, you agree as follows: You understand that BNMG Providers are not responsible for your care until attendance of your first appointment with the Provider.
