Proof Of Hospitalization

State:
Alaska
Control #:
AK-02014
Format:
Word; 
Rich Text
Instant download

Description Hospitalization Certificate

This is a notice of lien for medical services rendered by a hospital. Detailed reference is made to the services provided and amounts due. This lien is placed on an outstanding claim the patient may have against another person who allegedly caused the injuries that were treated by the hospital. Payment for the services is sought from the proceeds of any litigation or settlement of that claim.

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How to fill out Alaska Notice Of Lien For Medical Services By Hospital?

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Proof Of Hospitalization