I voluntarily consent to Vitality Urgent Care (VUG) and consent to treatment by the nurse practitioner on duty and whomever they may designate as their assistant, associate, physician, and patient care staff to provide my care. Such care may include but is not limited to, diagnostic testing and the administration of medications considered advisable in my diagnosis, treatment, and course of care. I acknowledge that no guarantee can be made or has been made as to the results of treatments or examinations and I understand that all medical treatments contain inherent risks.
I am aware that the practice of medicine is not an exact science and I acknowledge that no guarantees have been made to me as to the results of my examination or treatment at VUG. I acknowledge that treatment at VUG intended to address specific episodic illnesses or injury and is not intended to substitute for comprehensive care in lieu of a primary care physician or other specialized physicians. To provide the best chance for successful treatment, I accept responsibility to follow the advice of my treating provider including compliance with medications, discharge instructions and reevaluation with follow up or referral to specialty care. I agree to seek care in an Emergency Department of a hospital if my condition substantially changes. I further agree to hold harmless the medical providers and staff of VUG if fail to comply with the above conditions.
Patients at VUC will be treated regardless of race, color, age, national origin, disability or religion. Notwithstanding the above criteria, VUC reserves the right to refuse care to any individual who may have an unpaid balance, exhibits rude or disruptive behavior or any other reason at the discretion of the provider on duty.
