Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), patient should initial here. . Ef- fective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. __________. Ef- fective Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Ef- fective Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial here. . Ef- fective as of Effective a s the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), patient should initial here. . Ef- fective ______ Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date that it is signed (for example, emergency treatment), patient should initial herehere . . Ef- fective Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), ) patient should initial herehere _. . Ef- fective Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement
Retroactive Effect. If patient intends this agreement to cover services rendered before the date it is signed (for example, emergency treatment), patient should initial here: . . Ef- fective Effective as of the date of first professional services.
Appears in 1 contract
Sources: Arbitration Agreement