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EXHIBIT III: SAMPLE CONTRACT ENTITY AUDIOLOGIST SERVICES AGREEMENT This Audiologist Services Agreement (Agreement) is entered into by and between the County of Santa Clara, a political subdivision
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How to fill out audiologist services agreement

01
Review the audiologist services agreement template to understand the terms and conditions.
02
Fill in the names and contact information of both parties involved - the audiologist and the client.
03
Specify the services to be provided by the audiologist, including any limitations or exclusions.
04
Outline the payment terms, including the total fee and any additional charges.
05
Include clauses related to confidentiality, liability, and termination of the agreement.
06
Have both parties review the agreement carefully before signing to ensure mutual understanding and agreement.
07
Sign and date the agreement to make it legally binding.

Who needs audiologist services agreement?

01
Individuals seeking audiology services such as hearing tests, hearing aid fittings, and hearing loss management.
02
Audiologists who want to formalize their services and protect their rights and responsibilities.
03
Healthcare facilities or organizations that employ audiologists and want to establish clear terms for service provision.
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An audiologist services agreement is a contract between an audiologist and a patient that outlines the services to be provided, the terms of payment, and the responsibilities of both parties.
Audiologists are required to file the audiologist services agreement with their patients before providing any services.
The audiologist services agreement should be filled out by both the audiologist and the patient, detailing the services to be provided, fees, payment terms, and any other relevant information.
The purpose of the audiologist services agreement is to establish clear expectations and responsibilities for both the audiologist and the patient, ensuring that both parties understand the terms of the agreement.
The audiologist services agreement must include details such as the services to be provided, fees, payment terms, cancellation policy, and any other relevant information deemed necessary.
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