Tennessee Patient Consent and Doctor's Lien

You have a right to get paid for medical services rendered. Get patients to sign this Tennessee Patient Consent and Doctor's Lien when providing treatment for third party injuries.

• The patient consents to the release of his/her medical information to support the patient's personal injury claim.
• The patient will be liable for paying the full amount of the medical provider's fees, whether or not the claim is successful.
• The medical service provider has an irrevocable lien on any settlement or damages awarded to the patient and the patient's attorney is instructed to satisfy the lien out of those proceeds.
• The patient will notify the medical provider if he/she retains new legal counsel.

The Tennessee Patient Consent and Doctor's Lien form will ensure that your bills are paid. Download it today.