|
HOME /
VIDEOS /
TRAFFIC STOPS /
ACTIVISM /
PHILOSOPHY /
VACCINES /
CONTRACTS |
|
NOTICE TO HEALTHCARE PROVIDER DOWNLOAD DOCUMENT - CLICK HERE or email feedback(keyboard shift-2)freedomtaker.com. You may edit the document as you wish. It is your document. We do not guarantee any outcome or results. We are not responsible for your use of this form or any consequences of your use of this form. SUGGESTED USE: 1) Edit the text as you wish. Add your patient information to the form. 2) Present the document to the receptionist at the healthcare provider's office as soon as you sign in. 3) Ask the receptionist to file the form with your patient records. 4) Make note of the receptionist's name and the time and date you presented the document to him/her. 5) Keep that note with your medical records with a copy of the form. 6) You only need to do this once per Healthcare Provider, not on every visit. 7) If your Healthcare Provider violates any of the terms on the notice, send them a copy of the notice, remind them that they have the notice in their records, they have agreed to those terms, and demand that they comply with the terms of the notice. 8) In any dispute or legal action, include the document and an affidavit stating when the form was presented and to whom. There are legal codes which support all positions on the form. |