Products tagged with 'new york lien form'
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New York Patient Consent and Doctor's Lien
This New York Patient Consent and Doctor's Lien form can ensure that your fees for medical services are paid by placing a lien on damages awarded in an injury claim.
- Patients receiving treatment for third party injuries (including on-the-job accidents) should sign this agreement before treatment begins.
- The legal action may necessitate access to the patient's medical records. The form includes a section where the patient authorizes the hospital to release that information.
- 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.
- This is a downloadable legal form in MS Word format.
- Intended for use only in the State of New York.
$6.29
New York Extension of Notice of Mechanic's Lien
Extend your mechanic's lien under Section 17 of the New York Lien Law with this Extension of Notice of Mechanic's Lien form.
- Section 17 of the Lien Law allows a contractor or supplier to extend its lien for an additional one year period in certain circumstances.
- A copy of Section 17 is included with the document for your reference.
- This is a reusable lien form. Pay for the form once, use it as often as required.
- Available as a Microsoft Word download.
- Intended to be used only in the State of New York.
$4.99
