医疗服务协议书范本五篇.docx

医疗服务协议书范本五篇
文章一：医疗服务协议书范本
中文：
医疗服务协议书
甲方：医疗机构名称
乙方：患者姓名
鉴于甲方是一家具有合法资质的医疗机构，提供专业的医疗服务；乙方是一名需要接受医疗治疗的患者，双方本着平等自愿、互惠互利的原则，达成以下协议：
第一条 服务内容
1.甲方承诺向乙方提供符合医疗标准的医疗服务，包括但不限于诊断、治疗、康复等服务。
2.甲方将根据乙方的病情和需求，制定个性化治疗方案，并及时进行治疗。
第二条 服务费用
1.乙方应当按照甲方公示的收费标准支付服务费用，并尽可能提供医疗保险资料以便报销。
2.如有其他需要额外收费的项目，应当提前告知乙方并取得乙方同意。
第三条 服务责任
1.甲方将尽最大努力保证医生和护理人员的专业水准，并对乙方提供负责任的医疗服务。
2.乙方在接受医疗服务过程中，应当按照医护人员的指导配合治疗，并主动告知病史及过敏情况。
第四条 保密协议
1.甲方对乙方的个人信息应当严格保密，未经乙方同意不得泄露任何有关乙方的隐私信息。
2.乙方也应当尊重医护人员的隐私，不得擅自拍照或录像，并不得公开医疗机构内部情况。
第五条 其他事项
1.凡涉及本协议未尽事项，应当双方协商解决，如无法达成一致意见，应当依法解决。
2.本协议自双方签字盖章即生效，有效期从开始治疗之日起至治疗结束。
甲方（盖章）：　　　　　　　　　 乙方（签字）：　　　　　　
日期：　　　　　　　　　　　　　　 日期：　　　　　　
英文：
Medical Service Agreement
Party A: Name of Medical Institution
Party B: Patient's Name
Whereas Party A is a legally qualified medical institution providing professional medical services, and Party B is a patient in need of medical treatment, the parties, based on the principles of equality, voluntariness, mutual benefit, hereby agree as follows:
Article 1 Service Scope
1. Party A undertakes to provide Party B with medical services that meet medical standards, including but not limited to diagnosis, treatment, and rehabilitation services.
2. Party A will tailor personalized treatment plans for Party B based on their condition and needs, and provide timely treatment.
Article 2 Service Fees
1. Party B shall pay the service fees according to the fee schedule publicized by Party A and provide medical insurance information for reimbursement if possible.
2. Party B shall be informed in advance and obtain consent for any additional chargeable items.
Article 3 Service Responsibility
1. Party A will make every effort to ensure the professional standards of doctors and nurses, and provide Party B with responsible medical services.
2. Party B should cooperate with treatment according to the guidance of medical staff during the medical service, and actively disclose medical history and allergies.
Article 4 Confidentiality Agreement
1. Party A shall strictly keep Party B's personal information confidential and shall not disclose any privacy information about Party B without Party B's consent.
2. Party B should also respect the privacy of medical staff, not take photos or videos without permission, and not disclose internal information of the medical institution.
Article 5 Other Matters
1. Any matters not covered by this agreement shall be resolved through consultation between the two parties. If no consensus can be reached, legal means should be taken.
2. This agreement shall take effect upon signature and seal of both parties and shall be valid from the start of treatment until the end of treatment.
Party A (Seal):　　　　　　　　　　 Party B (Signature):　　　　　　
Date:　　　　　　　　　　　　　　 Date:　　　　　　
文章二：医疗服务协议书范本
中文：
医疗服务协议书
甲方：医疗机构名称
乙方：患者姓名
鉴于甲方为一家提供专业医疗服务的合法医疗机构，乙方为一名需求接收医疗治疗的患者，双方均同意签订本协议，内容如下：
第一条 服务项目
1. 甲方承诺向乙方提供符合医疗标准的专业医疗服务，包括但不限于检查、诊断、治疗、康复等项目。
2. 甲方将根据乙方的病情和需求，制定个性化的治疗方案，并保证治疗效果。
第二条 服务费用
1. 乙方应按照甲方规定的收费标准支付服务费用，如有医疗保险报销的，应主动提供相关资料以便协助报销。
2. 如在治疗过程中需要额外收费的项目，甲方应提前告知乙方，并得到乙方同意。
第三条 服务承诺
1. 甲方保证医护人员具有专业资质，并将为乙方提供高质量的医疗服务。
2. 乙方在接受医疗服务期间，应配合医护人员的治疗，按规定服用药物，不擅自更改治疗方案。
第四条 保密协议
1. 甲方应对乙方的个人信息严格保密，未经乙方同意不得泄露任何私人信息。
2. 乙方也不得擅自泄露医护人员的隐私，保护医疗机构的社会形象。
第五条 其他事项
1. 本协议未尽事宜，可经双方协商变更，如双方无法达成一致，按法律规定解决。
2. 本协议自双方签字盖章即生效，有效期自治疗开始日起至治疗结束。
甲方（盖章）：　　　　　　　　　 乙方（签字）：　　　　　　
日期：　　　　　　　　　　　　　　 日期：　　　　　　
英文：
Medical Service Agreement
Party A: Name of Medical Institution
Party B: Patient's Name
Whereas Party A is a legally qualified medical institution providing professional medical services and Party B is a patient in need of medical treatment, both parties agree to sign this agreement, the content is as follows:
Article 1 Service Items
1. Party A undertakes to provide Party B with professional medical services that meet medical standards, including but not limited to examinations, diagnosis, treatment, rehabilitation, etc.
2. Party A will tailor personalized treatment plans for Party B based on their condition and needs and ensure treatment effectiveness.
Article 2 Service Fees
1. Party B shall pay the service fees according to the fee schedule set by Party A. If there is medical insurance for reimbursement, Party B should provide relevant information for assistance in reimbursement.
2. If additional chargeable items are required during the treatment process, Party A shall inform Party B in advance and obtain Party B's consent.
Article 3 Service Commitment
1. Party A guarantees that medical staff have professional qualifications and will provide Party B with high-quality medical services.
2. During the provision of medical services, Party B should cooperate with medical staff, take medication as prescribed, and not change the treatment plan without authorization.
Article 4 Confidentiality Agreement
1. Party A shall strictly keep Party B's personal information confidential and shall not disclose any private information about Party B without Party B's consent.
2. Party B shall not disclose medical staff's privacy without authorization, protecting the social image of the medical institution.
Article 5 Other Matters
1. Matters not covered by this agreement may be changed by mutual agreement between the two parties. If no consensus can be reached, legal means should be taken.
2. This agreement shall take effect upon signature and seal of both parties and shall be valid from the start of treatment until the end of treatment.
Party A (Seal):　　　　　　　　　　 Party B (Signature):　　　　　　
Date:　　　　　　　　　　　　　　 Date:　　　　　　
文章三：医疗服务协议书范本
中文：
医疗服务协议书
甲方：医疗机构名称
乙方：患者姓名
鉴于甲方为一家合法医疗机构，提供专业医疗服务；乙方为一名需接受医疗治疗的患者，双方同意签订以下协议：
第一条 服务内容
1. 甲方将向乙方提供符合医疗标准的医疗服务，包括诊断、治疗、康复等。
2. 甲方将制定并执行针对乙方的个性化治疗方案，保证医疗服务的及时性和有效性。
第二条 服务费用
1. 乙方应按照甲方公布的收费标准支付医疗服务费用，配合办理医疗保险报销手续。
2. 如需进行额外的收费项目，甲方应提前告知乙方，并经乙方同意后执行。
第三条 服务承诺
1. 甲方将保证医生和护理人员具有专业资质，确保提供高质量的医疗服务。
2. 乙方应按照医护人员的指导遵循治疗方案，积极配合治疗，自觉告知医疗史及过敏情况。
第四条 保密义务
1. 甲方应承担对乙方个人信息严格保密的义务，未经乙方同意不得泄露任何隐私信息。
2. 乙方也应尊重医护人员的隐私，不得私自拍照或录像，并保护医疗机构的声誉。
第五条 其他事项
1. 对于本协议未尽事宜，双方应协商解决，若不能达成一致，应依法处理。
2. 本协议自签字盖章之日起生效，有效期从治疗开始之日起至治疗结束。
甲方（盖章）：　　　　　　　　　 乙方（签字）：　　　　　　
日期：　　　　　　　　　　　　　　 日期：　　　　　　
英文：
Medical Service Agreement
Party A: Name of Medical Institution
Party B: Patient's Name
Whereas Party A is a legal medical institution providing professional medical services, and Party B is a patient in need of medical treatment, both parties agree to sign the following agreement:
Article 1 Service Content
1. Party A will provide Party B with medical services that meet medical standards, including diagnosis, treatment, rehabilitation, etc.
2. Party A will formulate and implement personalized treatment plans for Party B, ensuring the timeliness and effectiveness of medical services.
Article 2 Service Fees
1. Party B shall pay the medical service fees according to the fee schedule publicized by Party A and cooperate in handling medical insurance reimbursement procedures.
2. If additional chargeable items are required, Party A shall inform Party B in advance and execute them with Party B's consent.
Article 3 Service Commitment
1. Party A will ensure that doctors and nursing staff have professional qualifications to provide high-quality medical services.
2. Party B should follow treatment plans according to the guidance of medical staff, actively cooperate with treatment, and voluntarily disclose medical history and allergies.
Article 4 Confidentiality Obligation
1. Party A shall strictly keep Party B's personal information confidential and shall not disclose any private information about Party B without Party B's consent.
2. Party B should also respect the privacy of medical staff, not take photos or videos without permission, and protect the reputation of the medical institution.
Article 5 Other Matters
1. For matters not covered by this agreement, both parties should resolve them through negotiation. If no consensus can be reached, legal means should be taken.
2. This agreement shall take effect upon signature and seal of both parties and shall be valid from the date of signing until the end of treatment.
Party A (Seal):　　　　　　　　　　 Party B (Signature):　　　　　　
Date:　　　　　　　　　　　　　　 Date:　　　　　　
文章四：医疗服务协议书范本
中文：
医疗服务协议书
甲方：医疗机构名称
乙方：患者姓名
鉴于甲方为一家合法医疗机构，提供专业医疗服务；乙方为一名需求接受医疗治疗的患者，双方同意签订以下协议：
第一条 服务内容
1. 甲方将向乙方提供符合医疗标准的医疗服务，包括但不限于检查、诊断、治疗、康复等。
2. 甲方将根据乙方的病情和需求，制定个性化的治疗方案，并保证治疗效果。
第二条 服务费用
1. 乙方应按照甲方制定的收费标准支付服务费用，如有医疗保险报销的，应主动提供相关资料以便协助报销。
2. 如在治疗过程中需要额外