Examples of UC Health in a sentence
PATIENT/LEGAL REPRESENTATIVE RELATIONSHIP TO THE PATIENT Printed Name: Date: If your provider is located on the University of Cincinnati Medical Center Campus, Xxxxxx Xxxxx Center for Post-Acute Care Campus, West Xxxxxxx Hospital Campus, return the completed acknowledgement form to UC Health through any one (1) of the following methods.
We are legally required to provide you with a copy of our NOTICE OF PRIVACY PRACTICES the first time you receive care at UC Health.
I understand the information in this document or otherwise given by me to UC Health will be used in submitting claims for payment for services rendered to me or the patient named below, and I certify that such information is correct.
I authorize UC Health and my physician, or the below named patient’s physician, dentist, surgeon or podiatrist, to have the results of these tests.
Disclaimer for electronic transmission By submitting this form, I understand and acknowledge, that if I decide to complete these forms and send them back to UC Health via this email exchange, UC Health cannot control and is not responsible for any compromised transmission of the email from your email server, or any compromise of your information that occurs with your email server storage.
I understand that a separate hospital facility charge will be billed to me or the health insurance plan in connection with the treatment and services provided by UC Health in such clinics.
I understand that some of the physicians who render professional services at UC Health are independent practitioners and are not employees or agents of UC Health.
I authorize UC Health to obtain blood samples for testing of communicable or sexually transmitted diseases including, but not limited to HIV and hepatitis, if a physician orders the test for diagnostic purposes for me or the patient named below or in the event a healthcare worker has been exposed to my blood or bodily fluids, or the blood or bodily fluids of the patient named below.
UC Health is not responsible for the acts or omissions of physicians who are not directed or controlled by UC Health.I further understand that I will be billed by the individual physicians for services they render to me or the patient named below.
Some of the UC Health outpatient clinics operate as Hospital-Based Clinics.