ContractTreatment and Payment Agreement • January 11th, 2021
Treatment and Payment AgreementTreatment and Payment Agreement • March 21st, 2014
Treatment and Payment AgreementTreatment and Payment Agreement • October 18th, 2016
TREATMENT AND PAYMENT AGREEMENTTreatment and Payment Agreement • January 5th, 2017
Treatment Consent and Authorization: I consent and authorize Dr. Leslie Murphy-MD, P.C. to examine me and perform all treatments for this and all following visits; including, without limitation, prescribed medications, performance of diagnostic procedures and laboratory tests as deemed necessary or advisable by the attending physician . This consent and authorization is given in advance of any specific diagnosis or treatment and is continuing until revoked in writing.
