Family doctor agreement, when it involves interests, everyone must sign a contract to protect the interests of both parties, so it is binding. After all, oral agreements are easy to break and there is no guarantee. When signing the agreement, we should pay attention to the legality of the agreement and look at the family doctor agreement together.

Family doctor agreement 1

Party A:

Party B: (representative of family members)

Home Phone: Mobile Phone: Address: Family Health FileNo.:

Party A * * * agrees that the Second Team of Town Health Center shall be signed by Party B's family doctor.

Contract service team. Captain: Tel: [1* * * *] Team members are as follows:

Family doctor: () Family nurse: (Yang Hongmei)

Security personnel: (Li Jintao) Village doctor: ()

Party A and Party B sign this Agreement on the principle of equality, respect and voluntariness, and accept the following terms:

1. As a service provider, Party A provides basic medical and public health services.

Party B and its family members provide the following two types of 15 services:

Member of Party B 1 (service item serial number:)

Member 2 of Party B (service item serial number:)

Member 3 of Party B (service item serial number:)

Member 4 of Party B (service item serial number:)

Member 5 of Party B (service item serial number:)

Member 6 of Party B (service item serial number:)

(1) signing free service projects

1. Establish family and personal health records for contracted residents;

2, distribution of health education publicity materials, to carry out health education lectures;

3. Carry out planned immunization and health care services for children aged 0-6;

4. Health management services for pregnant women;

5. Provide health examination and health management services for the elderly aged 65 and above once a year;

6, for patients with hypertension and type 2 diabetes, physical examination once a year, not less than 4 times a year face to face.

Health management services;

7, for patients with severe mental illness, physical examination once a year, not less than 4 times a year face to face.

Management services;

8. Evaluate the personal health status of contracted residents and formulate personalized health guidance;

9. Accept the telephone health consultation of the contracted family members;

10, carrying out outpatient appointment service and two-way referral service;

1 1. Help disabled people make rehabilitation plans and guide and supervise rehabilitation training;

12. Provide on-site health consultation and guidance clothing for empty nesters or elderly people with mobility difficulties.

Service;

13. Individualized TCM constitution identification of family members and TCM health care service;

14. Provide family health counseling and health support as needed.

(2) Personalized special needs services

15. Grassroots medical and health institutions provide basic medical services and other paid services to contracted residents in their jurisdiction according to their needs, and the charging standards shall be implemented in accordance with relevant documents.

2. Party B and its family members voluntarily accept the above-mentioned selected services and report their health status.

1. Inform Party A in time to ensure smooth communication and actively cooperate with Party A's services.

This agreement is made in duplicate, one for each party, and shall come into effect as of the date of signature by both parties, including

Valid for one year. If it is necessary to terminate the contract after the expiration, Party B shall notify Party A and both parties shall sign for confirmation. Don't propose a solution.

The contract is deemed to be automatically renewed.

Party A (seal): Party B (signature):

Year, month, sun, moon, sun.

Family doctor agreement 2 Party A (family doctor):

Service station address:

Contact telephone number:

Party B (customer):

Home address:

Contact telephone number:

In order to improve the health level of residents in this area and standardize the responsibilities and obligations of Party A and Party B during the contract service period, Party A and Party B reached an agreement through consultation on the principle of mutual benefit and voluntariness according to the relevant provisions of the Family Doctor System Service in North Huang Da.

I. Responsibility of Party A

1. Party A's staff shall provide civilized and scientific services and respect and protect Party B's family privacy.

2. Provide basic medical and public health services for Party B's family.

3. Establish health records for Party B's family.

4. Provide various types of health education for Party B's family.

5. Provide regular follow-up and health intervention for key objects such as chronic patients and disabled people in Party B's family.

6. Provide Party B with referral guidance and make an appointment for expert services in superior hospitals.

Two. Obligations of Party B

1. Party B shall respect and understand the work and services of Party A's doctors.

2. Party B shall cooperate with the medical and health services provided by family doctors and relevant medical personnel.

3. Party B shall cooperate with the family doctor to improve the family file information.

4. Party B shall voluntarily participate in various health knowledge publicity lectures organized by Party A. ..

5. Party B shall follow the health intervention and chronic disease treatment plan of Party A's doctor.

6. Party B voluntarily cooperates with family doctors to complete other work items required for community public health services.

3. Any breach of this Agreement by either party is a breach of contract, and the observant party has the right to terminate this Agreement.

Four. This agreement shall come into effect after being signed by Party A, stamped with Party A's official seal and signed by Party B, and shall be valid for one year.

5. This Agreement is made in duplicate, with each party holding one copy. If it is necessary to terminate the contract after the expiration, Party B shall notify Party A and both parties shall sign for confirmation. Failure to terminate the contract is regarded as automatic renewal.

Signature of Party A (family doctor): Signature of Party B (client):

Date: Year Month Day Date: Year Month Day

Party A's signature confirmation: Party B's signature confirmation:

Family doctor agreement 3 Party A:

Name of village doctor in village clinic: Tel: 1 Name of township doctor in hengjiang town Health Center: Tel:

County-level medical institutions: doctor's name: Tel:

Name of Helping Cadres: Unit: Tel:

Party B: Name of the leader of the villagers' team in the administrative village:

Family population: Tel: 1

Instructor: Hengjiang (Town) Health Center Tel: 0797-XXX

In order to improve the level of health services and health assistance such as medical treatment, prevention, health care, rehabilitation, etc. for the poor households who have set up the card, and give full play to the role of contracted family doctors and supporting cadres in the work of health poverty alleviation, based on the principle of equality and voluntariness, Party B voluntarily hires Party A as the contracted service doctor and supporting cadres of the family and becomes the service object of Party A. This agreement is signed by Party A, Party B and the guiding unit through consultation.

I. Responsibility of Party A

Party A provides Party B with the following services:

1. Be responsible for notifying Party B to receive public health services at the designated place according to the unified arrangement of the guiding unit. Conduct 1 family health assessment for contracted families every year, and make personalized health plans according to the assessment results. Rural doctors are followed up at least once a week, and township health center staff are followed up at least once a month. County doctors are responsible for health consultation, medical guidance and other services. Doctors at all levels should make follow-up records and establish work accounts.

2, free distribution of health education prescriptions and medical science materials. Distribute health education materials to contracted residents in a timely manner, with no less than 1 copy per year; Inform contracted residents of health activities such as health classes or health education lectures and seasonal and sudden public health events in time, at least 1 time every year.

3. Establish health records (including electronic files) free of charge for all poor households who set up files and set up cards, and implement dynamic management. According to the health status and needs of residents, family members over the age of 65 are given a free physical examination once a year, children aged 0-6 are given vaccination management, pregnant women are systematically managed before and after delivery, and patients with chronic diseases such as hypertension and diabetes and patients with severe mental illness are provided with active health consultation and classified guidance services at least six times a year. The consultation results and service information shall be timely entered into the rural residents' health management information system or reported to the guidance unit. The health examination and management of all kinds of personnel shall be carried out in accordance with the requirements of the implementation plan of urban and rural basic public health service projects.

4. Provide 24-hour free telephone consultation and give health, prevention and health care guidance.

5. Investigate and manage the health status of Party B and its members on a regular basis through outpatient service, telephone call and door-to-door visits. And make health measures and disease prevention plans for them. Help contact referral in case of emergency.

6. All helping cadres should vigorously publicize the five lines of medical security for the poor, namely, the medical security system of "basic medical insurance+serious illness insurance+supplementary medical insurance for diseases+medical assistance+civil emergency", and provide medical expense reimbursement policies, procedures and policy consultation related to health and poverty alleviation.

7. Every half a month, each helping cadre should take the initiative to understand the health status of the assisted object, provide timely guidance on medical treatment for diseases, help them contact their counterparts, and track the treatment of diseases and reimbursement of medical expenses. For poor households whose medical expenses are reimbursed by basic medical insurance, serious illness insurance, supplementary medical insurance and medical assistance, there are still high out-of-pocket expenses, which may lead to poverty and return to poverty due to illness. Helping cadres should report to the township (town) in a timely manner.

The above seven services are basic services, and there is no charge. Both parties to the agreement can increase and refine the service items through consultation. For the family members of Party B who are inconvenient to move, they can provide on-site service and set up family beds. On the premise that Party A informs Party B that there are medical risks in home treatment, with the consent of both parties, Party A and Party B carry out home treatment, and the expenses shall be implemented according to relevant national document standards. If special expenses are involved, they shall be determined by both parties through consultation.

In order to ensure that Party B can get the household contract service in time, Party A shall provide the service in time after receiving Party B's application for help. When Party A has special medical tasks or it is difficult to guarantee on-site service for other reasons, it may request the guidance unit to assign other rural doctors to provide on-site service.

Two. Party B's responsibilities

1. All family members of Party B actively cooperate with Party A to carry out the above services, timely and accurately inform Party A of their physical health status, changes and health-related information and materials, and ensure the authenticity and legality of relevant information and materials.

2. When Party A's on-site service is needed, Party B shall make an appointment with Party A in advance.

3. Actively participate in and cooperate with various activities related to disease prevention and control carried out by Party A, and earnestly implement the relevant measures for disease prevention and control formulated by Party A or the guiding unit.

Three. The guiding unit should strengthen the management of Party A, make plans for the distribution of publicity materials and the schedule of physical examination, and provide technical support and logistical support for Party A in the process of serving Party B. ..

4. If Party B is not satisfied with Party A's service, it can complain to the guidance unit, or ask the guidance unit to coordinate and solve it, or even apply for changing the contracted doctor.

5. During the service provided by Party A to Party B, if Party B conceals the medical history information from Party A, or fails to implement the prevention and treatment plan formulated by Party A, or refuses to listen to the guidance, the service quality will be affected, and the consequences will be borne by Party B. ..

6. This agreement shall come into effect as of the date of signing, and shall be made in triplicate, with Party A, Party B and the guidance unit holding one copy respectively. The validity period is one year, and it will automatically terminate upon expiration.

Seven. This protocol is a trial version. In case of conflict with relevant national laws and regulations, the national laws and regulations shall prevail.

Party A: signature of village doctor: Party B (signature):

Signature of township doctor:

Signature of county-level doctor:

Help cadres sign:

Date, year and month