Jersey City New Jersey Patient - Attorney Medical Lien Agreement

Category:
State:
Multi-State
City:
Jersey City
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.
Free preview
  • Form preview
  • Form preview

Trusted and secure by over 3 million people of the world’s leading companies

Jersey City New Jersey Patient - Attorney Medical Lien Agreement