Selected family doctor agreements. In life, people often use agreements to protect their own interests. After all, the agreement is protected by law. After the other party violates the agreement, it can immediately terminate the agreement and get some compensation. Let's look at the choice of family doctor agreement.
Family doctor agreement 1 Party A:
Rural clinics:
Name of village doctor:
Contact telephone number:
Party B:
Name of head of household:
Number of family members:
Contact telephone number:
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. Regularly investigate and manage the health status of Party B and its members through outpatient service, telephone call, door-to-door visits, etc., and make healthy living 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
Family doctor agreement II Party A: Contact number of doctor:
Party B (family representative): ID number:
Fixed telephone: mobile telephone:
Home address:
Party C: Lianping County Health Center
According to the relevant regulations of family doctor service in Lianping County, Party A, Party B and Party C have _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
1. Responsibilities of Party A (family doctor): Provide standardized basic medical care and basic public health services according to the regulations of the Health Planning Commission. The specific service items are as follows:
(a) the establishment of family health records, protect the privacy of files.
(two) to provide telephone consultation service for the contracted families, and the service time is:
Monday to Friday morning (8: 00 to 12: 00).
Afternoon (14: 30 to 17: 30)
(three) to provide targeted services for the following different family members:
1. Carry out routine physical examination, mental health guidance and family nursing guidance (assessment of geriatric function scale, prevention guidance of geriatric diseases, health education) once a year for the elderly aged 65 and above.
2. Provide systematic health care management guidance services (such as regular physical examination, development assessment, health care guidance and vaccination guidance) for children aged 0-6 in family members, and conduct home visits to newborns.
3. Provide pregnant women with five pregnancy guidance and two postpartum visits, and provide women with health care counseling (family planning counseling, pre-pregnancy health care, reproductive health, mental health guidance, etc.). ).
4. Provide health education and health guidance for children and women who need family members.
5. Provide health system management and referral services for family members with chronic diseases such as hypertension and diabetes.
(4) To provide health self-help management services such as family life cycle guidance, family function evaluation and family health intervention plan for signed families.
(five) to provide electronic medical records, health check-up information and other health records storage and query for families who file cards. Provide opportunities for families who have signed contracts to obtain health education materials and information and read them online (distribute health prescriptions).
(six) to provide medical consultation services such as making an appointment for medical treatment, family sickbed, referral consultation, etc. for families who have established a card.
(seven) to provide paid medical services for family members who have established contracts.
(8) In case of emergency, Party B shall promptly report to 120 for first aid, and Party A shall assist 120 for first aid. Special door-to-door service should be provided within the agreed time, but no invasive treatment is allowed. At the same time, it will not bear the legal responsibility caused by the change of Party B's condition.
(nine) to fulfill the obligation of health information.
Two. Responsibilities and obligations of Party B (community residents):
(1) Provide detailed address information and personal data.
(2) Provide real personal health information.
(three) to provide guarantee for each appointment.
(four) to make an appointment for family doctors to make home visits.
(five) regular management and maintenance of personal and family information.
(six) regular physical examination according to the requirements of family doctors.
(VII) Obey the arrangement of Party A during the medical treatment.
(8) Settle the paid items in time.
Three. Responsibilities of Party C (primary health care center):
(1) Strengthen the management of Party A and provide support and logistical support from other departments for Party A in the process of serving Party B. ..
(2) To undertake the diagnosis and treatment of patients referred by Party A, and charge fees according to regulations.
4. When the contract expires, if Party B is not satisfied with Party A, it may ask Party C to settle it through consultation or apply for re-selecting a family doctor. Family doctors have the right not to renew their contracts if they think they are not suitable for each other.
This agreement shall come into force as of the date of signing, and the agreement and its annexes have the same legal effect, and the validity period is one year. This agreement is made in triplicate, with Party A, Party B and Party C holding one copy respectively.
Signature of Party A:
Signature of Party B:
Signature (Seal) of Party C:
Date of signature: year month day.
Family doctor agreement 3 Party A: the village family doctor team of Guoyang Township Health Center (service center).
Party B (head of household or representative): health recordNo.: 34 162 1 mobile phone: landline: home address: family members: the team of family doctors of Party A and Party B agree to provide community health services for Party B ... family doctor's mobile phone:
Based on the principles of equality, respect and resources, Party A and Party B sign the following terms:
I. Responsibility of Party A
1. Provide Party B with the following free services:
(1) Notify Party B to accept public health services. According to the work arrangement, notify Party B to receive public health services at the designated place. Conduct 1 family health assessment for contracted families every year, and make personalized health plans according to the assessment results.
(2) distributing health education materials. Distribute health education prescriptions and medical popular science materials printed by the unit to the contracted residents in a timely manner, not less than 1 species per year; Inform the contracted residents of health activities, seasonal disease prevention and control, public health emergencies and other information in a timely manner, not less than 1 time every year.
(3) Carry out health management services. Establish health records for all family members and implement dynamic management. According to the residents' health status and needs, do a good job in health management services for the elderly over 65 years old, children aged 0-6 years old and pregnant women, and screen, follow-up, intervene and guide patients with hypertension, diabetes and severe mental illness. The consultation results and service information are entered into the resident health management information system in time. Its service and management are in accordance with the requirements of Anhui Basic Public Health Service Standard (20 1 1 Edition).
(4) Provide health consultation and guidance. Provide 24-hour telephone consultation and give health, prevention and health care guidance.
(5) Make a disease prevention plan. 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 formulate healthy living measures and disease prevention plans for them.
2. Provide services agreed by both parties to Party B. Both parties can increase the service items through negotiation. With the consent of both parties, under the premise of informing Party B of the medical risks of family medical treatment, Party A can provide on-site medical services for Party B's family members with mobility difficulties, and the charges shall be implemented according to the relevant national document standards.
3. Contact the recommendation service. If Party B's illness exceeds Party A's diagnosis and treatment level and ability, Party A shall not accept the consultation without authorization, but shall actively inform Party B to transfer to a higher medical institution for treatment; And actively assist Party B to contact the superior medical appointment service and fulfill the referral procedures.
4. Ensure that Party B can get the signing service in time. Party A shall provide services in time after receiving Party B's application for help; When Party A has special medical tasks or cannot provide services for other reasons, it shall actively coordinate and arrange other doctors to serve it.
Two. Party B's responsibilities
1, providing health-related information. Party B and its family members shall actively cooperate with Party A to carry out the above services, inform Party A of health-related information in a timely and accurate manner, and ensure the authenticity and legality of relevant information and materials.
2. Make an appointment for on-site service. When Party A's on-site service is needed, Party B shall make an appointment with Party A in advance and reach an agreement.
3. Implement disease prevention and control measures. Actively participate in and cooperate with various disease prevention and treatment activities carried out by Party A, and conscientiously implement the relevant measures for disease prevention and treatment formulated by Party A. ..
4. Feedback Party A's service. If Party B is dissatisfied with Party A's service, it can complain to the head of the general practice team or the director of the community health service center, or even change the contracted doctor. Supervisory complaint telephone number: 7239020
5, bear the consequences of not complying with the regulations. In the process of accepting Party A's service, if Party B conceals medical history information from Party A, or fails to implement the prevention and treatment plan formulated by Party A or disobeys the guidance, the service quality will be affected, and the adverse consequences will be borne by Party B. ..
3. This agreement shall come into effect as of the date of signing, in duplicate, one for each party, and the validity period is 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. Failure to terminate the contract is regarded as automatic renewal.
Four. 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): Party B (signature):
Year, month, sun, moon, sun.