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Appendix 1
Services and Payment Terms
1. Medical Services. As used in this Agreement, the term Medical Services shall be defined as
those medical services that the Physicians are
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How to fill out medical services agreement
01
Step 1: Read through the entire medical services agreement carefully to understand its terms and conditions.
02
Step 2: Fill in your personal information, such as your name, address, contact details, and any identification numbers required.
03
Step 3: Provide accurate and detailed information about your medical history, including any pre-existing conditions or allergies.
04
Step 4: Review and understand the scope of the medical services being provided and any associated costs or fees.
05
Step 5: Sign and date the agreement, indicating your acceptance of the terms and your agreement to comply with them.
06
Step 6: Keep a copy of the filled-out medical services agreement for your records.
Who needs medical services agreement?
01
Anyone seeking medical services from a healthcare provider or facility may need a medical services agreement.
02
This includes patients, individuals, or entities entering into a contractual relationship with a medical professional or institution.
03
Medical services agreements may also be required for insurance purposes or as part of legal and regulatory requirements.
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