Products tagged with 'illinois lien form'
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Illinois Doctor's Lien and Patient Consent Form
Do you treat patients who have been injured by accident or third parties. Have them sign this Illinois Doctor's Lien and Patient Consent Form at the time of treatment.
- The patient gives his/her consent for the treatment and authorizes the medical practitioner to release any information required to conduct the patient's injury claim.
- Regardless of the outcome of the claim, the patient will be personally liable for paying the medical bills.
- The doctor has an irrevocable lien on any settlement or damages awarded to the patient. The patient's lawyer is instructed to satisfy the lien out of the settlement proceeds.
- The patient must give notice if he/she hires a different attorney.
- Intended for use only in the State of Illinois.
$12.49
Illinois Owner's Sworn Statement under Mechanics Lien Act
The Illinois Mechanics Lien Act requires any property owner who is having improvements done to their property to execute this Owner's Sworn Statement.
- The law requires you to make the Sworn Statement to protect the lien rights of all the subtrades and suppliers that have provided labor, materials or services with respect to the improvements.
- The form includes a schedule setting out the contract amounts, amounts paid to each contractor to date, and the balance due to each (if any).
- This form is a downloadable MS Word document.
- Intended for use only in the State of Illinois.
$6.29
