Common Contracts

4 similar Patient Agreement contracts

Patient Agreement
Patient Agreement • December 30th, 2023 • Arizona

The Practice, located at 5950 S COOPER RD STE 1 CHANDLER AZ, 85249 provides ongoing primary care medicine to its Members in a direct pay, membership model (DPC). In exchange for certain periodic fees, the Practice agrees to provide You with the Services described in this Agreement under the terms and conditions contained within.

PATIENT AGREEMENT
Patient Agreement • August 4th, 2023 • Georgia

The Practice, located at 101 PILGRIM VILLAGE DR, STE 400, CUMMING, GA 30040 provides ongoing primary care medicine to its Members in a direct pay, membership model (DPC). In exchange for certain periodic fees, the Practice agrees to provide You with the Services described in this Agreement under the terms and conditions contained within.

PATIENT AGREEMENT
Patient Agreement • August 4th, 2023 • Georgia

The Practice, located at 101 PILGRIM VILLAGE DR, STE 400, CUMMING, GA 30040 provides ongoing primary care medicine to its Members in a direct pay, membership model (DPC). In exchange for certain periodic fees, the Practice agrees to provide You with the Services described in this Agreement under the terms and conditions contained within.

HILTS DIRECT PRIMARY CARE, PLLC PATIENT AGREEMENT
Patient Agreement • May 24th, 2022 • North Carolina

The Practice, located at 411 PARKWAY AVE, SUITE E1, GREENSBORO, NC 27401, provides ongoing primary care medicine to its Members in a direct pay, membership model (DPC). In exchange for certain periodic fees, the Practice agrees to provide You with the Services described in this Agreement under the terms and conditions contained within.