Common Contracts

Fiscal Year 20XX Contractual Agreement BETWEEN {{NAME OF CMHSP}} AND {{NAME OF INPATIENT FACILITY}} For the purpose of: Psychiatric Inpatient Services

Psychiatric Inpatient Agreement • April 2nd, 2020 • Michigan

• Contract Type
  Psychiatric Inpatient Agreement
• Filed
  April 2nd, 2020
• Jurisdiction
  Michigan

THIS AGREEMENT FOR PROVIDER SERVICES (this “Agreement”) is made and entered into on this 1st day of October, XXXX, by and between {{CMHSP}} whose administrative office address is {{CMHSP ADDRESS}} (hereinafter referred to as the “PAYOR” or “CMHSP,” and {{PROVIDER NAME]], whose business address is {{PROVIDER ADDRESS}} (hereinafter referred to as the “Provider”).