All Providers Are Independent Contractors

INDEPENDENT MEDICAL PROVIDER SERVICES ACKNOWLEDGMENT I, ACKNOWLEDGE AND FULLY UNDERSTAND THAT ANY LICENSED MEDICAL PROVIDER, INCLUDING BUT NOT LIMITED TO PHYSICIANS, SURGEONS, ANESTHESIOLOGISTS, REGISTERED NURSES, CERTIFIED REGISTERED NURSE ANESTHETISTS, ESTHETICIANS, MEDICAL DOCTORS, AND ALL OTHER CLINICIANS (“MEDICAL PROVIDERS”), WHO PROVIDE CARE, TREATMENT, OR PERFORM PROCEDURES FOR ME, ARE NOT EMPLOYEES OR AGENTS OF THE SURGERY CENTER OR MEDICAL CLINIC, BUT ARE INSTEAD INDEPENDENT CONTRACTORS. I UNDERSTAND AND ACKNOWLEDGE THAT THE SURGERY CENTER AND MEDICAL CLINIC DO NOT CONTROL THE MEDICAL DECISIONS MADE BY THE MEDICAL PROVIDERS. EACH MEDICAL PROVIDER EXERCISES THEIR OWN PROFESSIONAL AND MEDICAL JUDGMENT IN PROVIDING CARE, TREATMENT, OR PERFORMING PROCEDURES FOR ME, AND IS SOLELY RESPONSIBLE FOR THEIR ACTIONS, DECISIONS, AND CARE. I AGREE THAT I WILL NOT HOLD THE SURGERY CENTER, MEDICAL CLINIC, OR THEIR STAFF LIABLE FOR THE ACTIONS, DECISIONS, OR CONDUCT OF ANY MEDICAL PROVIDER, AS I UNDERSTAND THAT THEY ARE INDEPENDENT AND NOT UNDER THE EMPLOYMENT OR CONTROL OF THE SURGERY CENTER OR MEDICAL CLINIC.