Monocacy definition
Examples of Monocacy in a sentence
Acknowledgement of Receipt of HIPAA Regulation Notice from Monocacy Start Center: I, the undersigned, hereby acknowledge that I have read and understand all parts of Monocacy Start Center’s notice of privacy rights under HIPAA regulations.
While I may discuss you or your child’s care with other treating providers at Monocacy Start Center in order to provide you with the most comprehensive care possible, I will not discuss treatment or release information outside of Monocacy Start Center without your written permission.
As a Board Certified Behavior Analyst at the Monocacy Start Center, I offer services without regard to age, race, gender, or religious affiliation.
Monocacy Surgery Center, LLC verifies insurance benefits, however exact coverage and benefits cannot be determined until the claim is received and reviewed by my insurance carrier.
Please check one of the following: NOTICE OF FINANCIAL RESPONSIBILITY: I understand that I am financially responsible to Monocacy Surgery Center, LLC for any and all charges associated with the services rendered by Monocacy Surgery Center, LLC, whether through a self-pay arrangement or assignment of applicable medical benefits under which I am a covered beneficiary.
Unless specifically instructed otherwise, Monocacy Surgery Center, LLC and each attending or treating practitioner are hereby authorized and directed, during the period of this admission, to disclose information to the patient’s spouse, children, parents, and any other person authorized to consent to treatment pursuant to 431.061-.065, RSMO (1979) as amended, concerning the patient’s health status, diagnosis, prognosis, and progress.
NOTICE OF POLICY REGARDING ADVANCE DIRECTIVES: I have received information about the Advanced Directives Policy at Monocacy Surgery Center, LLC and I understand that the center policy (regardless of the contents of any advance directive or instructions from a health care surrogate attorney in fact) is to initiate resuscitative measures, should an adverse event occur during my procedure.
In the event that a dividend reinvestment plan has been established by the Board of Directors of Monocacy Bancshares, Inc., Employee shall participate in such dividend reinvestment plan with respect to all shares of Bank Stock received pursuant to this Agreement and all shares of Bank Stock received pursuant thereto shall be subject to the restrictions imposed on the underlying Bank Stock awarded pursuant to this Agreement.
Each share of Bank Stock issued to Employee pursuant to this Agreement shall be valued as of the date of the issuance of such Bank Stock to Employee at that value for Bank Stock established pursuant to a dividend reinvestment plan adopted for Bank Stock by the Board of Directors of Monocacy Bancshares, Inc.
PHYSICIAN OWNERSHIP DISCLOSURE: Monocacy Surgery Center, LLC provides services only to patients admitted by private practitioners who are members of the Medical Staff, some of whom retain joint ownership of the surgery center.