MEDICAL TREATMENT AGREEMENT (CONDITION OF ADMISSION)Medical Treatment Agreement • March 15th, 2011
ASSUMPTION OF RISK, RELEASE OF LIABILITY AND CONSENT TO EMERGENCY MEDICAL TREATMENT AGREEMENTMedical Treatment Agreement • August 1st, 2022
I, ___________________________, (“Participant”) in consideration of my participation in the Enter the Event Name (“Event”), on behalf of myself, my assigns, and my heirs, expressly and knowingly agree to indemnify, defend, and hold harmless the Enter the Name of the RSO (hereinafter: “Sponsor”), Board of Regents of the Nevada System of Higher Education, on behalf of the University of Nevada, Las Vegas (“UNLV”), its officers, agents, employees, and volunteers, for any and all claims, demands, and/or causes of action for property damage, personal injury, or death sustained by me arising out of the Event conducted by or under the auspices of Sponsor, including, but not limited to, the selection and/or provision of emergency medical services. (Initial beside each item below)
Medical Treatment AgreementMedical Treatment Agreement • October 20th, 2020
I, the undersigned owner of , my dog, do hereby authorize and consent to such medical services or care which in the sole judgment of Doggie Depot, Inc. is necessary or appropriate for my dog, including the selection of veterinary personnel and facilities and the transfer of my dog to such facilities. I authorize and consent to all emergency, surgical, diagnostic, and corrective treatment and procedures deemed by duly licensed veterinarians to be necessary for the life, health and well being of my dog. It is understood that reasonable efforts shall be made to contact the undersigned prior to rendering treatment to my dog, but I agree that necessary treatment shall not be withheld if the undersigned cannot be reached.
Medical Treatment AgreementMedical Treatment Agreement • September 27th, 2016
This agreement between (Patient) and Andrologix Health and Wellness, LLC. and their parent company Nationwide Synergy, Inc. (Andrologix) establishes guidelines and conditions required for the use of hormone replacement therapy (HRT) involving DEA "controlled" or "scheduled" medications. Andrologix and Patient agree that these guidelines and conditions are an essential factor in maintaining a successful patient/physician relationship. Adverse side effects and/or physical/psychological dependence may develop after repeated use of these medications and therefore, these agents are prescribed with caution.
MEDICAL TREATMENT AGREEMENT (MTA)Medical Treatment Agreement • April 3rd, 2020
Patient or the patients’ legal representative agree to the following terms of encounters with one or more: Providers of Banner Health (which for purposes of this MTA includes Banner Urgent Care, Banner Medical Group, Banner University Medical Group, Banner Research, and Banner Alzheimer’s Institute) and/or in one or more Banner Health facilities:
Medical Treatment AgreementMedical Treatment Agreement • January 30th, 2014
Medical Treatment AgreementMedical Treatment Agreement • January 22nd, 2020
This agreement between (Patient) and Andrologix Health and Wellness, LLC. and their parent company Sozo Group, LLC (Andrologix) establishes guidelines and conditions required for the use of hormone replacement therapy (HRT) involving DEA "controlled" or "scheduled" medications. Andrologix and Patient agree that these guidelines and conditions are an essential factor in maintaining a successful patient/physician relationship. Adverse side effects and/or physical/psychological dependence may develop after repeated use of these medications and therefore, these agents are prescribed with caution.
MEDICAL TREATMENT AGREEMENT (MTA)Medical Treatment Agreement • September 1st, 2017
Patient or the patients’ legal representative agree to the following terms of encounters with one or more: Providers of Banner Health (which for purposes of this MTA includes Banner Urgent Care, Banner Medical Group, Banner University Medical Group, Banner Research, and Banner Alzheimer’s Institute) and/ or in one or more Banner Health facilities:
