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    Missouri Doctor's Lien and Patient Consent


    Secure the payment of your patient invoices with this Missouri Doctor's Lien and Patient Consent form.

    • Patients receiving treatment for third party injuries (including on-the-job accidents) should sign this agreement before treatment begins.
    • The patient consents to the treatment and authorizes the release of his/her medical information as required to document the patient's injury claim.
    • The patient gives the doctor an irrevocable lien on any settlement or damages awarded, which will then be used to pay the lien.
    • The patient agrees to be legally liable for paying the full amount of the health care provider's fees, regardless of the outcome of the claim.

    Stop worrying over whether your bills will get paid. Get the Missouri Doctor's Lien and Patient Consent form today.

    Download Type: Microsoft Word
    Last Updated: 14-April-2016
    SKU: 8358