Notice To Patients
An Open Payments Database Notice, for informational purposes only, is provided below in the form of a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The Open Payments database is at the following link:
https://openpaymentsdata.cms.gov
NOTICE AND ACKNOWLEDGMENT OF RECEIPT AND UNDERSTANDING
NOTICE TO PATIENTS
I have reviewed the above form and acknowledge that I have
been provided a link to the federal Centers for Medicare and
Medicaid Services (CMS) Open Payments web page.
NOTICE AND ACKNOWLEDGMENT OF RECEIPT AND UNDERSTANDING
NOTICE TO PATIENTS
I have reviewed the above form and acknowledge that I have
been provided a link to the federal Centers for Medicare and
Medicaid Services (CMS) Open Payments web page.
Please click the links below to download our printer-ready forms. You can fill them out prior to an appointment and bring with you at the time of your appointment.
Forms in English
Forms in Spanish
Make an appointment today with Endure Urgent Care. Call (424) 353-0003
A link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided for informational purposes only. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
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