Common use of Severability Provision Clause in Contracts

Severability Provision. In the event any provision(s) of this Agreement is declared void and/or unenforceable, such provision(s) shall be deemed severed therefrom and the remainder of the Agreement enforced in accordance with California law. I understand that I have the right to receive a copy of this agreement. By my signature below, I acknowledge that I have received a copy. NOTICE: BY SIGNING THIS CONTRACT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND YOU ARE GIVING UP YOUR RIGHT TO A JURY OR COURT TRIAL. SEE ARTICLE 1 OF THIS CONTRACT. By: By: Physician’s or Duly (Date) Patient’s Signature (Date) Authorized Representative Signature Print Patient’s Name By Print or Stamp Name of Physician, Medical Group or Association Name By: Patient’s Representative’s Signature (if applicable)(Date) By: Signature of Translator (if applicable) (Date) Print Name and Relationship to Patient

Severability Provision. In the event any provision(s) of this Agreement is declared void and/or unenforceable, such provision(s) shall be deemed severed therefrom and the remainder of the Agreement enforced in accordance with California lawthe law of the state of jurisdiction. I understand that I have the right to receive a copy of this agreement. By my signature below, I acknowledge that I have received a copy. NOTICE: BY SIGNING THIS CONTRACT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND YOU ARE GIVING UP YOUR RIGHT TO A JURY OR COURT TRIAL. SEE ARTICLE 1 OF THIS CONTRACT. By: By: Physician’s or Duly (Date) Patient’s Signature (Date) Authorized Representative Signature Print Patient’s Name By By: Print or Stamp Name of Physician, Medical Group or Association Name By: Patient’s Representative’s Signature (if applicable)(Dateapplicable) (Date) By: Signature of Translator (if applicable) (Date) Print Name and Relationship to Patient

Severability Provision. In the event any provision(s) of this Agreement is declared void and/or unenforceable, such provision(s) shall be deemed severed therefrom and the remainder of the Agreement enforced in accordance with California law. I understand that I have the right to receive a copy of this agreement. By my signature below, I acknowledge that I have received a copy. NOTICE: BY SIGNING THIS CONTRACT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND YOU ARE GIVING UP YOUR RIGHT TO A JURY OR COURT TRIAL. SEE ARTICLE 1 I OF THIS CONTRACT. By: By: Physician’s or Duly (Date) Patient’s Signature (Date) Date Authorized Representative Signature Print Patient’s Name By Print or Stamp Name of Physician, Medical Group or Association Name By: Patient’s RepresentativeSignature Date Print Patient’s Signature (if applicable)(Date) By: Name Signature of Translator (if applicable) Date Print Name of Translator Patient’ s Representative’s Signature (Dateif applicable) Print Name and Relationship to PatientPatient Date A signed copy of this document should be given to the patient. The original copy will be archived in the patient's medical file.

Severability Provision. In the event any provision(s) of this Agreement is declared void and/or unenforceable, such provision(s) shall be deemed severed therefrom and the remainder of the Agreement enforced in accordance with California law. I understand that I have the right to receive a copy of this agreement. By my signature below, I acknowledge that I have received a copy. NOTICE: BY SIGNING THIS CONTRACT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND YOU ARE GIVING UP YOUR RIGHT TO A JURY OR COURT TRIAL. SEE ARTICLE 1 OF THIS CONTRACT. By: By: Physician’s or Duly (Date) Patient’s Signature (Date) Authorized Representative Signature Print Patient’s Name By By: By: Print or Stamp Name of Physician, Medical Group or Association Name By: Patient’s Representative’s Signature (Date) Medical Group or Association Name (if applicable)(Dateapplicable) By: Signature of Translator (if applicable) (Date) Print Name and Relationship to PatientPatient Print Name of Translator

Severability Provision. In the event any provision(sprovision (s) of this Agreement is declared void and/or unenforceable, such provision(s) shall be deemed severed therefrom and the remainder of the Agreement enforced in accordance with California law. I understand that I have the right to receive a copy of this agreement. By my signature below, I acknowledge that I have received a copy. NOTICENOTICE : BY SIGNING THIS CONTRACT YOU ARE AGREEING TO HAVE ANY ISSUE OF MEDICAL MALPRACTICE DECIDED BY NEUTRAL ARBITRATION AND YOU ARE GIVING UP YOUR RIGHT TO A JURY OR COURT TRIAL. SEE ARTICLE 1 OF THIS CONTRACT. By: By: Physician’s or Duly (Date) Patient’s Signature (Date) Authorized Representative Signature By: By: Print or stamp Name of Physician (Date) Print Patient’s Name By Print or Stamp Name of Physician, Medical Group or Association Name By: Patient’s Representative’s Signature (if applicable)(Date) By: Signature of Translator (if applicable) (Date) Patient’s Representative Signature. (Date) Print Name and Relationship to Patientof Translator