Attachment Agreement for Patients of Dr. Corcoran, Hislop, Lee, and Sambor

For patients of Dr.’s Corcoran, Hislop, Lee, and Sambor *only*:
 
You may have recently received an email from us regarding “Patient Attachment”.
 
Here again is the “Attachment Agreement” you are being asked to confirm:
 
"As your primary care provider I, along with my practice team, agree to:

• Provide you with safe and appropriate care
• Coordinate any specialty care you may need
• Offer you timely access to care, to the best of my ability and as reasonably possible in the circumstances
• Maintain an ongoing record of your health
• Keep you updated on any changes to services offered at my clinic
• Communicate with you honestly and openly so we can best address your health care needs

 
As my patient I ask that you:

• Seek your health care from me and my team whenever possible and, in my absence, through my colleague(s)
• Name me as your primary care provider if you have to visit an emergency facility or another provider
• Communicate with me honestly and openly so we can best address your health care needs”

 
Here is the link to the form we are asking you to complete (same form as in the email - you only need to complete the form once PER person, but it must be done for every individual, including children) to indicate your/their agreement with this “Attachment” document: https://forms.gle/GAxNzeAQ6EaUPKEK9
 
Thank-you for your attention to this matter. Have a great day!
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