Scribd Logo
Upload

Welcome to Scribd!

  • 0a Vault Coercion

    Uploaded by

    UncoverDC
    53 views1 page
    0a Vault Coercion

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    0a Vault Coercion

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    53 views1 page

    0a Vault Coercion

    Uploaded by

    UncoverDC
    0a Vault Coercion

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    of 1
    VAULT cunicarnesernch covinsoLuioNS WORKFORCE SCREENING SPECIALTY CARE ea > South Carolina: | understand that there is value to having primary care medical home and, if request, Vault shall provide assistance in identifying available options for a primary care medical home. > Vermont: | understand that | have the right to be informed of any party who willbe present at the site during the telehealth consult and | have the right to exclucle anyone from being present. | understand that | have the right to receive a consult with a distant-site provider and will receive one upon request immediately or within a reasonable time after the results of the initial consult. VT Stat, Ann, § 9361 understand that the terms herein are contractuall and not a mere recital and that | electroniccily sign this document as my own free act and void of any coercion. The permissions granted herein shall begin on the date listed above and shaill remain effective until terminated by me. ‘Withholding, Withdrawing, oF Revoking Consent: lunderstandl that Ihave the right €o withhold or withdraw my consent at any time by submitting a request via email to [email protected]. | understand that | may withhold or withdraw my consent granting access to my medication history through electronic prescribing, platforms and/or computer networks, as described above, which will not affect my abilty to recelve medical care. ‘Terms and Conditions of Payment Receipt of health care services from Vault and a Vault Medical Group Practice Provider, and my use of the Platform in connection with such health care services, constitutes an ongoing agreement to these Terms and Conditions of Payment (the “Terms and Conditions of Payment’). Capitalized terms used here but not otherwise defined shail have the meaning given to such terms in the above Telehealth Informed Consent Form. | understand that these Terms and Conditions of Payment apply only to the extent a third party, such as my employer, is not responsible for payment for the services provided to me by Vault's and the Vault Medical Group Practice Providers.

    You might also like