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Patient - Attorney Medical Lien Agreement

 Patient - Attorney Medical Lien Agreement
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State:
Multi-State
Control #:
US-LIEN-01
Instant Download
$12.95
Mail Paper Copy
$16.95
Available formats: Word | Rich Text

Description

This form is a Medical Lien Agreement. The clien authorizes a health care provider to furnish his/her attorney with prepaid copies of certain medical records relevant to the client's injury or accident. The client also acknowledges that he/she is directly responsible to the health care provider for all medical bills submitted by them for services rendered.

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