Release & Settlement Agreement (Medical Expenses)

This Release and Settlement Agreement is between a patient and a medical provider who agrees to render services to the patient and receive payment through a settlement which the patient receives from an insurance company. This settlement agreement sets forth the date of any signed Lien and Insurance Assignment and the total amount due for the rendered services. It also sets out that this is the final agreement between the parties. It is imperative that this agreement be clearly set out in writing. (continued ...)