SINGLE PATIENT SERVICES AGREEMENTSingle Patient Services Agreement • July 21st, 2021 • Florida
This PATIENT SERVICES AGREEMENT (“Agreement”) is between OneMed Florida, LLC, a Florida Limited liability company, d/b/a OneMed Clinic of Lake Nona, located at 10129 Clear Vista Street, Orlando, Florida, 32832 (“OneMed”), Sonita Khan, M.D., Reynald Lamarre, M.D. , Peter Ganpat, M.D. Carlos Ruiz, M.D., Luis Allen, M.D. (collectively “Physicians”) in their capacity as an agents of OneMed, and you, (Patient), on date as noted by the electronic signature.
