Texas Patient Consent and Doctor's Lien

Secure payment of your medical fees by getting your patients to sign this Texas Patient Consent and Doctor's Lien Agreement before treatment begins.

  • The patient authorizes the doctor / hospital to release any information about his/her injury and treatment for purposes of the personal injury claim.
  • Regardless of the outcome of the injury claim, the patient is personally responsible for paying the fees.
  • The medical provider has an irrevocable lien over any amounts awarded to the patient. The patient's attorney is directed to satisfy the lien out of the settlement funds.
  • This is a reusable legal form. Once you've purchased it, you can use it as often as you like.
  • The template can be customized for your specific business needs.
  • Intended for use only in the State of Texas.
Document Type: Microsoft Word
Last Updated: 09-August-2021
SKU: 870
$12.49
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