Statement of interpreter Sample Clauses

Statement of interpreter. (where appropriate) I have interpreted the information above to the patient to the best of my ability and in a way in which I believe she/he can understand. Signed....................................................................................... Date.................................................. Name (PRINT).........................................................................................................................................
AutoNDA by SimpleDocs
Statement of interpreter. (where appropriate) I have interpreted the above information to the child and those with parental responsibility to the best of my ability and in a way in which I believe they can understand. Signed …………………………………………….…………………… Date .…………………………….…..…….. Name (PRINT) …………………..…………………………Contact details …………….……………………… Statement and signature of person with parental responsibility You will be offered a copy of this form. If you have any further questions, do ask – we are here to help you and your child. You have the right to change your mind at any time, including after you have signed this form. The guidance notes in the inside front cover of the Consent Form Book set out the circumstances in which a person may have parental responsibility for a child. I confirm that I have parental responsibility for this child. I understand: • the information that I have been given about the examination or treatment described on this form. • that you cannot give me a guarantee that a particular person will perform the procedure. The person will, however, have appropriate experience. • that the child and I will have the opportunity to discuss the details of anaesthesia with an anaesthetist before the procedure, unless the urgency of the situation prevents this. (This only applies to children having general or regional anaesthesia). • that any procedure in addition to those described on this form will only be carried out if it is necessary to save the life of the child or to prevent serious harm to his or her health. I agree to the procedure or course of treatment described on this form. I have been told about additional procedures which may become necessary during the child’s treatment. I have listed below any procedures which I do not wish to be carried out without further discussion (refusal of some procedures may mean the health professional has to obtain legal advice). …………………………………………………………….………………………………………………………..……. …………………………………………………………………………….…………………………………..…………. I do / do not agree* that students may be present during the procedure (*please delete as appropriate). Signature …..………………………………………….…………..…… Date ...………………………..……...……. Name (PRINT) ……………………………………… Relationship to the child ..………….….………………… Child’s agreement to treatment (if child wishes to sign) I agree to have the treatment I have been told about. Name ………………………………..…………….................. Signature ……………………….………………… Date …………………..……………………..…. Confirmation of consent (to be completed by a health profess...

Related to Statement of interpreter

  • Statement of Intent The Agent and each Noteholder intend that the Notes be classified and maintained as a grantor trust under subpart E, part I of subchapter J of chapter 1 of the Code that is a fixed investment trust within the meaning of Treasury Regulation §301.7701-4(c), and the parties will not take any action inconsistent with such classification. It is neither the purpose nor the intent of this Agreement to create a partnership, joint venture, “taxable mortgage pool” or association taxable as a corporation among the parties.

  • STATEMENT OF FACTS 1. The Superintendent of Insurance is the official charged with administering and enforcing Maine’s insurance laws and regulations, and the Bureau of Insurance is the administrative agency with such jurisdiction.

  • Treatment of Interest For Federal and State tax purposes (i) interest shall accrue at the Accrual Rate, and (ii) payments made pursuant to section 2 shall first be treated as interest, up to the amount of interest so accrued, then shall be treated as principal, until Purchaser has received, as principal, the entire Principal Amount, and then shall be treated as interest.

  • Agreed Statement of Facts The parties shall develop an agreed statement of facts and shall exchange reliance documents prior to the hearing. Disclosure of relevant or potentially relevant documents is a mutual and ongoing obligation before and during the particular hearing.

  • Court Appearance Leave Leave shall be granted for appearance before a court, legislative committee, or other judicial or quasi-judicial body in response to a subpoena or other direction of proper authority for job related purposes other than those instituted by the employee or the exclusive representative. Leave shall also be granted for attendance in court in connection with an employee's official duty, which shall include any necessary travel time. Such employee shall be paid for the employee's regular rate of pay but shall remit to his/her Appointing Authority the amount received, exclusive of expenses, for serving as a witness, as required by the court. Unpaid leave shall be granted for other appearances before a court, judicial or quasi-judicial body in response to a subpoena.

  • Professional Seal Where applicable in the determination of the City, the first page of a technical report, first page of design specifications, and each page of construction drawings shall be stamped/sealed and signed by the licensed professional responsible for the report/design preparation.

  • Statement of Services Service Attachments The services to be delivered by Provider (the “Services”) and the fees for those Services, and the specific terms applicable to those Services are described in the Order or in one or more Service Attachments referencing this Agreement. Except for Supplemental Services or Project Services (described below), and unless otherwise agreed in writing, the services we will deliver to you are limited to those Services specifically identified in the Order and described in the Service Attachments. In the event of any conflict between the terms of a Service Attachment and this Agreement, the terms in the Service Attachment control. In the event of any conflict between the terms of an Order and any Service Attachment or this Agreement, the terms of the Order control. Provider may decline to perform any services requested by the Client that are in violation of any applicable law or that are not typically associated with the Services provided by Provider. Supplemental Services “Supplemental Services” are limited, additional services and equipment you may need on a “one-off” or emergency basis that are not included within the scope of the Services described in an Order or the applicable Service Attachments. You will incur additional Service Fees for Supplemental Services. We will notify you of any such additional Service Fees and will obtain your approval prior to providing them. However, we have no obligation to determine the need for or to provide any Supplemental Services. All Supplemental Services are provided on an “as-is” basis and include no warranties of any kind, whether express or implied. In addition, if we determine that any additional services you request would be inappropriate for treatment as Supplemental Services under this paragraph, we may deliver to you a proposed Service Attachment for Project Services or a Proposal prior to providing Supplemental Services. Project Services In some cases, you may ask us to deliver services outside the scope of any Order or Service Attachment and inappropriate for treatment as Supplemental Services. Examples of such services include major system upgrades, new computer, machine or device setup, network changes, datacenter moves or setups, or installations. In those cases, we will prepare a separate Service Attachment for Project Services describing the proposed scope of those services and our fee to deliver them. Installation dates are estimates only. Customer shall be responsible for preparation and maintenance of the site for such Project Services or installations, including, but not limited to, providing necessary electrical power and communication lines and proper air conditioning and humidity control. FEES FOR SERVICES | PAYMENT TERMS Service Fees Fees for Services are set forth in Order or Statement of Work. Unless otherwise indicated in writing, all Services will be performed on a time-and-materials basis at Provider’s then-current rates.

  • Statement of Operations d. Statement of Changes in Net Assets.

  • Nurse Representatives The Employer agrees to recognize two (2) Nurse Representatives for the purpose of dealing with grievances and conducting Union interviews.

  • Statement of Understanding By executing this Agreement, Employee acknowledges that (a) Employee has had at least twenty-one (21) or forty-five (45) days, as applicable in accordance with the Age Discrimination in Employment Act, as amended, (the “ADEA”) to consider the terms of this Agreement [and any attachment necessary or desirable in accordance with the ADEA] and has considered its terms for such a period of time or has knowingly and voluntarily waived Employee’s right to do so by executing this Agreement and returning it to Company; (b) Employee has been advised by Company to consult with an attorney regarding the terms of this Agreement; (c) Employee has consulted with, or has had sufficient opportunity to consult with, an attorney of Employee’s own choosing regarding the terms of this Agreement; (d) any and all questions regarding the terms of this Agreement have been asked and answered to Employee’s complete satisfaction; (e) Employee has read this Agreement and fully understands its terms and their import; (f) except as provided by this Agreement, Employee has no contractual right or claim to the benefits and payments described herein; (g) the consideration provided for herein is good and valuable; and (h) Employee is entering into this Agreement voluntarily, of Employee’s own free will, and without any coercion, undue influence, threat, or intimidation of any kind or type whatsoever. HAVING READ AND UNDERSTOOD THIS AGREEMENT, CONSULTED COUNSEL OR VOLUNTARILY ELECTED NOT TO CONSULT COUNSEL, AND HAVING HAD SUFFICIENT TIME TO CONSIDER WHETHER TO ENTER INTO THIS AGREEMENT, THE UNDERSIGNED HEREBY EXECUTE THIS AGREEMENT ON THE DATES SET FORTH BELOW. EMPLOYEE JDA SOFTWARE GROUP, INC. By: Date: Date:

Time is Money Join Law Insider Premium to draft better contracts faster.