Enrolment Form Sample Clauses

Enrolment Form. 1. I confirm that:
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Enrolment Form. During the term of this Agreement, patients who are invited to enrol in accordance with sections 3.1 and 3.2 shall be provided with the patient Enrolment Form and Consent to Release Personal Information, in the form appended hereto as Appendix “A:.. The Enrolment Form shall become effective upon its completion and signing by the patient and the acknowledgement of the FHO Physician thereon. Upon the full completion of the Enrolment Form by the patient and the FHO Physician, the FHO Physician shall provide a copy to the patient. In the event that the FHO Physician is a Medicine Professional Corporation, patients shall be assigned to an individual voting shareholder designated by that corporation to act as its agent for the purposes of enrolment, including completing with the patient the Enrolment Form.
Enrolment Form. During the term of this Agreement, patients who are invited to enrol in accordance with sections 3.1 and 3.2 shall be provided with the patient Enrolment Form and Consent to Release Personal Information, in the form appended hereto as Appendix A. The Enrolment Form shall become effective upon its completion and signing by the patient and the acknowledgement of the FHN Physician thereon. Upon the full completion of the Enrolment Form by the patient and the FHN Physician, the FHN Physician shall provide a copy to the patient.

Related to Enrolment Form

  • ENROLMENT 6.1.0 For new hires, each Board shall distribute benefit communication material as provided by the Union to all new members within 15 to 30 days from their acceptance of employment.

  • Enrollment The School shall maintain accurate and complete enrollment data and daily records of student attendance.

  • Re-enrollment Any eligible employees who wish to join the Sick Leave Bank after their first year of eligibility will contribute two (2) days upon joining. Such membership may only be made during the month of October using the appropriate forms. The two (2) required days of leave shall be donated from their account upon enrollment in the Classified Employee Council (CEC).

  • Grievance Form A form that must be used for filing of grievances, provided herein as Attachment D, shall be provided by the school district. Such form shall be readily accessible in all school buildings.

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