REQUIREMENT FOR BINDING ARBITRATION ALL DISPUTES, INCLUDING CLAIMS OF NURSING MALPRACTICE. CALIFORNIA HEALTH AND SAFETY CODE SECTION 1363.1 AND INSURANCE CODE SECTION 10123.19 REQUIRE SPECIFIED DISCLOSURES IN THIS REGARD, INCLUDING THE FOLLOWING NOTICE: "IT IS UNDERSTOOD THAT ANY DISPUTE AS TO NURSING MALPRACTICE, THAT IS AS TO WHETHER ANY NURSING SERVICES RENDERED UNDER THIS CONTRACT WERE UNNECESSARY OR UNAUTHORIZED OR WERE IMPROPERLY, NEGLIGENTLY OR INCOMPETENTLY RENDERED, WILL BE DETERMINED BY SUBMISSION TO ARBITRATION AS PROVIDED BY CALIFORNIA LAW, AND NOT BY A LAWSUIT OR RESORT TO COURT PROCESS EXCEPT AS CALIFORNIA LAW PROVIDES FOR JUDICIAL REVIEW OF ARBITRATION PROCEEDINGS. BOTH PARTIES TO THIS CONTRACT, BY ENTERING INTO IT, ARE GIVING UP THEIR CONSTITUTIONAL RIGHT TO HAVE ANY SUCH DISPUTE DECIDED IN A COURT OF LAW BEFORE A JURY, AND INSTEAD ARE ACCEPTING THE USE OF ARBITRATION." BOTH PARTIES ALSO AGREE TO GIVE UP ANY RIGHT TO PURSUE ON A CLASS BASIS ANY CLAIM OR CONTROVERSY AGAINST THE OTHER. EITHER PARTY WILL NOT GO PUBLIC REGARDING ANY WRONG DOING NOR DISCUSS THIS MATTER USING THE MEDIA, RADIO, WRITTEN PUBLICATIONS, OR THE INTERNET. ALL CLAIMS WILL BE PRIVATELY HANDLED. |
I agree to binding arbitration as described above. Please check the box on the Reservation page inorder to secure a Reservation.If you cancel on the day of your surgery or you are unable to come to our retreat on the day of your surgery, or you cancel services while being rendered for any reason, whether it is a non-medical or medical reason, NO refunds will apply. Patient has read the Policy page and Cancellation policy. By signing below, he/she understands and agrees to Tina Sherman's terms. Sign ___________________________________date:___________________________ Please mail this form with your payment. Thank you. |