Seriously ill definition
Examples of Seriously ill in a sentence
I will/did provide the following CARE (please specify) to my SERIOUSLY ILL FAMILY MEMBER (Name of Seriously ill family member) Who is my (check one): Spouse Parent Child under 18 Child 18 or over incapable of self care Print Employee Name Employee Signature Date I have read the DEFINITIONS on the reverse side and I certify that the individual named above as the SERIOUSLY ILL FAMILY MEMBER is my patient who suffers from a SERIOUS HEALTH CONDITION as defined.
If the Borrower fails to so reimburse the Issuing Bank by such time, the Administrative Agent shall promptly notify each Lender of the Honor Date, the amount of the unreimbursed drawing (the "Unreimbursed Amount"), and the amount of such Lender's Percentage Share thereof.
I will/did provide the following CARE (please specify) to my SERIOUSLY ILL FAMILY MEMBER (Name of Seriously ill family member) Who is my (check one): □ Spouse □ Parent □ Child under 18 □ Child 18 or over incapable of self care Print Employee Name Employee Signature Date I have read the DEFINITIONS on the reverse side and I certify that the individual named above as the SERIOUSLY ILL FAMILY MEMBER is my patient who suffers from a SERIOUS HEALTH CONDITION as defined.
I will/did provide the following CARE (please specify) to my SERIOUSLY ILL FAMILY MEMBER (Name of Seriously ill family member) Who is my (check one): ❑ Spouse ❑ Parent ❑ Child under 18 ❑ Child 18 or over incapable of self care Print Employee Name Employee Signature Date I have read the DEFINITIONS on the reverse side and I certify that the individual named above as the SERIOUSLY ILL FAMILY MEMBER is my patient who suffers from a SERIOUS HEALTH CONDITION as defined.
I will/did provide the following CARE (please specify) to my SERIOUSLY ILL FAMILY MEMBER (Name of Seriously ill family member) Who is my (check one): Spouse Parent Child under 18 Child 18 or over incapable of self care Print Employee Name Employee Signature Date CERTIFICATION BY HEALTH CARE PROVIDER I have read the DEFINITIONS on the reverse side and I certify that the individual named above as the SERIOUSLY ILL FAMILY MEMBER is my patient who suffers from a SERIOUS HEALTH CONDITION as defined.