Common Contracts
3 similar Program Agreement contracts
PROGRAM AGREEMENTProgram Agreement • February 14th, 2020 • New York
, 20 (the “Effective Date”), between you, the undersigned Patient (“You”), and Flatiron Family Medical, P.C. (the “Practice”), under which the Practice will make certain health and wellness services, amenities and enhanced services available to you which are not otherwise covered by commercial insurance, managed care, Medicare and/or other third party payers. By voluntarily entering into this Agreement and remitting the Annual Program Fee (as set forth below), you may participate in the Practice’s Concierge Medical Services Program (the “Program”) for a period of twelve (12) months beginning on the Effective Date.
PROGRAM AGREEMENTProgram Agreement • August 7th, 2018 • New York
This Program Agreement (this “Agreement”) is entered into and effective as of the day of , 20 (the “Effective Date”), between you, the undersigned Patient (“You”), and Flatiron Family Medical, P.C. (the “Practice”), under which the Practice will make certain health and wellness services, amenities and enhanced services available to you which are not otherwise covered by commercial insurance, managed care, Medicare and/or other third party payers. By voluntarily entering into this Agreement and remitting the Annual Program Fee (as set forth below), you may participate in the Practice’s Concierge Medical Services Program (the “Program”) for a period of twelve (12) months beginning on the Effective Date.
PROGRAM AGREEMENTProgram Agreement • August 7th, 2018 • New York
This Program Agreement (this “Agreement”) is entered into and effective as of the day of , 20 (the “Effective Date”), between you, the undersigned Patient (“You”), and Flatiron Family Medical, P.C. (the “Practice”), under which the Practice will make certain health and wellness services, amenities and enhanced services available to you which are not otherwise covered by commercial insurance, managed care, Medicare and/or other third party payers. By voluntarily entering into this Agreement and remitting the Annual Program Fee (as set forth below), you may participate in the Practice’s Concierge Medical Services Program (the “Program”) for a period of twelve (12) months beginning on the Effective Date.
