Read and Understood. I (Patient or Patient's representative) have read and I understand the above Agreement which has been verbally explained to me to my satisfaction. I understand that I have the right to have my questions about arbitration answered and I do not have any unanswered questions. I execute this agreement of my own free will and not under any duress, and I understand that my signing this Agreement is not a requirement in order to receive medical services from Physician.
Appears in 2 contracts
Samples: Arbitration Agreement, Arbitration Agreement
Read and Understood. I (Patient or Patient's ’s representative) have read and I understand the above Agreement which has been verbally explained to me to my satisfaction. I understand that I have the right to have my questions about arbitration answered and I do not have any unanswered questions. I execute this agreement of my own free will and not under any duress, and I understand that my signing this Agreement is not a requirement in order to receive medical services from Physician.
Appears in 1 contract
Samples: cranioutah.com
Read and Understood. I (Patient or Patient's ’s representative) have read and I understand the above Agreement which has been verbally explained to me to my satisfaction. I understand that I have the right to have my questions about arbitration answered and I do not have any unanswered questions. I execute this agreement of my own free will and not under any duress, and I understand that my signing this Agreement agreement is not a requirement in order to receive medical services from the Physician.
Appears in 1 contract
Samples: Arbitration Agreement
