PHYSICIAN’S SECTION Sample Clauses

The PHYSICIAN’S SECTION is a part of a contract or form specifically designated for completion by a licensed medical doctor. This section typically requires the physician to provide medical information, assessments, or certifications relevant to the subject of the agreement, such as confirming a diagnosis, outlining treatment plans, or verifying a patient’s fitness for work or participation. Its core practical function is to ensure that any medical statements or decisions within the document are validated by a qualified professional, thereby providing credibility and legal assurance regarding the medical aspects addressed.
PHYSICIAN’S SECTION. TO THE PHYSICIAN: Your patient is a teacher with the Chignecto-Central Regional School Board. The teacher has been absent from work due to illness since The Board requires information regarding the teacher’s current medical condition. Please complete this form only if you have treated the teacher during the illness in question, or have predetermined medical information that this individual has been ill since that date specified above. Your cooperation is appreciated. The teacher will require a receipt for any fee charged for obtaining this medical information. (1) Teacher’s Name: (2) Teacher’s Address: (3) Date(s) you attended the teacher: (4) Duration of current illness or injury: From To (5) Expected date of return to regular duties of work: (6) Has the patient’s current illness prevented him/her from reporting for and performing his/her job? Yes No (7) On the patient’s return to work are there restrictions on any activities the employee can engage in? (8) Physician’s Name and Address: Physician’s Signature Date Other remarks (use additional sheet if necessary)
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PHYSICIAN’S SECTION. TO THE PHYSICIAN: Your patient is a teacher with the Atlantic Provinces Special Education Authority. The teacher has been absent from work due to illness since . The Board requires information regarding the teacher’s current medical condition. Please complete this form only if you have treated the teacher during the illness in question, or have predetermined medical information that this individual has been ill since that date specified above. Your cooperation is appreciated. Any fee applicable to your completing this form should be billed directly to the Atlantic Provinces Special Education Authority.
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PHYSICIAN’S SECTION. TO THE PHYSICIAN: Your patient is a teacher with the Annapolis Valley Regional School Board. The teacher has been absent from work due to illness since . The Board requires information regarding the teacher’s current medical condition. Please complete this form only if you have treated the teacher during the illness in question, or have predetermined medical information that this individual has been ill since that date specified above. Your cooperation is appreciated. Any fee applicable to your completing this form should be billed directly to the Annapolis Valley Regional School Board. 1. Teacher’s Name: 2. Teacher’s Address:
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PHYSICIAN’S SECTION. TO THE PHYSICIAN: Your patient is an employee of the Due to the employee’s from work, the Board requires information concerning the employee’s current medical condition and the prognosis for this employee provid- ing regular attendance in the relatively near future. PLEASE COMPLETE THIS FORM ONLY IF YOU HAVE BEEN TREATING THE EMPLOYEE DURING THE ILLNESS IN QUESTION. YOUR COOPERATION IS APPRECIATED. Any charges made for the completion of this form should be forwarded to the School Board. Patient’s name: Patient’s address: you attended the employee: What is the employee’s medical condition: Duration of current illness or injury: FROM: TO: Has the patient had the same or similar condition before: YES NO (if YES, state when and describe the duration and any other relevant information)
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Related to PHYSICIAN’S SECTION

  • Reg Section 1.163-5(c)(2)(i)(D)(6);

  • IRC Section 409A This Agreement is intended to comply with Section 409A (as defined in Section 23 of this Agreement) and any ambiguous provisions will be construed in a manner that is compliant with the application of Section 409A. If (a) the Indemnitee is a “specified employee” (as such term is defined by the Company in accordance with Section 409A) and (b) any payment payable upon “separation from service” (as such term is defined by the Company in accordance with Section 409A) under this Agreement is subject to Section 409A and is required to be delayed under Section 409A because the Indemnitee is a specified employee, that payment shall be payable on the earlier of (i) the first business day that is six months after the Indemnitee’s “separation from service”; (ii) the date of the Indemnitee’s death; or (iii) the date that otherwise complies with the requirements of Section 409A. This Section 25 shall be applied by accumulating all payments that otherwise would have been paid within six months of the Indemnitee’s separation from service and paying such accumulated amounts on the earliest business day which complies with the requirements of Section 409A. For purposes of Section 409A, each payment or amount due under this Agreement shall be considered a separate payment, and the Indemnitee’s entitlement to a series of payments under this Agreement is to be treated as an entitlement to a series of separate payments.

  • Treasury Regulations The term "Treasury Regulations" means the Income Tax Regulations, including temporary regulations, promulgated under the Code, as such regulations may be amended from time to time.

  • CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CERTIFICATION Pursuant to Public Contract Code (PCC) section 2010, the following certifications must be provided when (i) submitting a bid or proposal to the JBE for a solicitation of goods or services of $100,000 or more, or (ii) entering into or renewing a contract with the JBE for the purchase of goods or services of $100,000 or more.

  • Section 280G of the Code Notwithstanding anything contained in this Agreement to the contrary, if the Executive would receive (i) any payment, deemed payment or other benefit as a result of the operation of Section 8 or 9 hereof that, together with any other payment, deemed payment or other benefit the Executive may receive under any other plan, program, policy or arrangement (collectively with the payments under Section 8 and 9 hereof, the “Covered Payments”), would constitute an “excess parachute payment” under section 280G of the Code that would be or become subject to the tax (the “Excise Tax”) imposed under Section 4999 of the Code or any similar tax that may hereafter be imposed, and (ii) a greater net after-tax benefit by limiting the Covered Payments so that the portion thereof that are parachute payments do not exceed the maximum amount of such parachute payments that could be paid to the Employee without Employee’s being subject to any Excise Tax (the “Safe Harbor Amount”), then the Covered Payments to the Executive shall be reduced (but not below zero) so that the aggregate amount of parachute payments that the Executive receives does not exceed the Safe Harbor Amount. In the event that the Executive receives reduced payments and benefits hereunder, such payments and benefits shall be reduced in connection with the application of the Safe Harbor Amount in the following manner: first, the Executive’s Severance Payment shall be reduced, followed by, to the extent necessary and in order, (i) the Target Cash Bonus; (ii) any the continuation of medical benefits, (iii) the Unvested RSU Bonus Shares and (iv) the Accrued Obligations. For purposes of determining whether any of the Covered Payments will be subject to the Excise Tax, such Covered Payments will be treated as “parachute payments” within the meaning of Section 280G of the Code, and all “parachute payments” in excess of the “base amount” (as defined under Section 280G(b)(3) of the Code) shall be treated as subject to the Excise Tax, unless, and except to the extent that, in the good faith judgment of a public accounting firm appointed by the Company prior to the Change in Control or tax counsel selected by such accounting firm (the “Accountants”), the Company has a reasonable basis to conclude that such Covered Payments (in whole or in part) either do not constitute “parachute payments” or represent reasonable compensation for personal services actually rendered (within the meaning of Section 280G(b)(4)(B) of the Code) in excess of the allocable portion of the “base amount,” or such “parachute payments” are otherwise not subject to such Excise Tax, and the value of any non-cash benefits or any deferred payment or benefit shall be determined by the Accountants in accordance with the principles of Section 280G of the Code.