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CONCIERGE PRACTICE PATIENT AGREEMENT This is an Agreement entered into on, 20, by and between ELLEN McDonald M.D. INC. located at 800 Fairmount Avenue, Suite 210 Pasadena CA 91105 (Practice), ELLEN
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What is concierge practice patient agreement?
Concierge practice patient agreement is a contract between a patient and a healthcare provider where the patient agrees to pay an annual fee or retainer for enhanced services and access to the provider.
Who is required to file concierge practice patient agreement?
It is the healthcare provider who is required to file the concierge practice patient agreement with the patient.
How to fill out concierge practice patient agreement?
To fill out a concierge practice patient agreement, both the healthcare provider and the patient need to review the terms and conditions, sign the agreement, and keep a copy for their records.
What is the purpose of concierge practice patient agreement?
The purpose of the concierge practice patient agreement is to establish a clear understanding of the services provided, fees, and obligations of both the healthcare provider and the patient.
What information must be reported on concierge practice patient agreement?
The concierge practice patient agreement should include details about the services provided, fees, payment terms, cancellation policy, and any other relevant information.
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