Patient-Provider AGREEMENTPatient-Provider Agreement • February 15th, 2017
Tell us about medications being taken, and ask for refills in a timely manner. Ask for your refills at the time of your office visit. Otherwise, give the office staff at least 24 hours notice to complete refills.
Specialist – Patient Provider AgreementPatient Provider Agreement • January 31st, 2022
We are partnering with your Primary Care Physician (PCP) who is your Patient Centered Medical Home. We are sharing their commitment to effectively and efficiently work together to manage your care. As your Specialist, we will be sharing information about your condition and provide recommendations, guidance and periodic follow-up.
PATIENT-PROVIDER AGREEMENT FOR CHRONIC PAIN TREATMENTPatient-Provider Agreement • August 16th, 2020
The purpose of this Agreement is to give the patient information about certain medications the patient will be taking for chronic pain management. This is to help both the patient and their provider comply with the law regarding controlled medications. Please read this contract thoroughly as it is a condition of your continued treatment. Your signature will be required.
PATIENT-PROVIDER AGREEMENT FOR ACUTE PAIN TREATMENTPatient-Provider Agreement • August 16th, 2020
other end-of-life care, or pain being treated as part of palliative care. The state of Oklahoma defines this period of time to last a maximum of two weeks.
PATIENT-PROVIDER AGREEMENT FOR DRIECT PRIMARY CARE SERVCIESPatient-Provider Agreement • April 8th, 2022 • Colorado
Telehealth NP, LLC representing various specialties through its Providers (i.e., pediatric, adult, family, geriatric, psychiatric or women’s health), delivers primary care within identified United States territories. In exchange for monthly membership fees, Telehealth NP, through its Providers, agrees to provide You (Patient) with the services described in this agreement on the terms and conditions contained therein.
THE PATIENT-PROVIDER AGREEMENTPatient-Provider Agreement • September 26th, 2017
The health and wellness of our patients is a top concern of this office. Providing the best possible care to every patient is our primary goal. The only way we can meet this goal is if I, your doctor, and you, my patient work together.
