CLEONA Partnership Agreement: Terms & Conditions
Organization Name
Point of Contact Name
Website
Email
Reproductive Health Services
Geographic Location(s) Served
By submitting this agreement, you acknowledge the following:
Your participation in CLEONA is entirely voluntary.
You consent to the inclusion of your professional information, including but not limited to your name, credentials, and contact details, on our platform.
The inclusion of your professional information is for the purpose of facilitating member access to provider details on our platform.
Members may use this information to seek services and make informed decisions based on your professional expertise.
Inclusion on the platform does not establish a provider-patient relationship and members are encouraged to communicate directly with providers for specific advice, diagnosis, or treatment.
The professional information provided in the agreement is accurate to the best of your knowledge and any changes to your professional details should be promptly updated with our platform.
You have read, understood, and consent to the inclusion of your professional information on our platform under the terms and conditions outlined in this disclaimer.
By checking this box and submitting this form, I acknowledge and agree to the terms and conditions outlined in this agreement.Please agree and submit this form by entering you full name and date:
Name
Date *
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