Indianapolis Indiana Patient - Attorney Medical Lien Agreement
Category:
State:
Multi-State
City:
Indianapolis
Control #:
US-LIEN-01
Format:
Word;
Rich Text
Instant download
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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