Common Contracts

PATIENT AGREEMENT

Patient Agreement • July 13th, 2020 • Florida

• Contract Type
  Patient Agreement
• Filed
  July 13th, 2020
• Jurisdiction
  Florida

This PATIENT AGREEMENT ("Agreement") specifies the terms and conditions between Balanced Physician Care, P.A. , a Florida professional association (“BPC") located at 115 Professional Drive Suite 104, Ponte Vedra Beach, Florida and , (hereinafter "Patient"), under which Patient may participate in the Balanced Physician Care Program, effective as of (the "Effective Date"). (Patient and BPC may each be referred to as a “Party” and collectively as “Parties”).