Waiver of Liability for Treatment
The Medical/Dental treatment provided by Bethesda Health Clinic, a charitable non-profit organization (the “Clinic”), is provided by volunteer healthcare providers who do not receive compensation.
Texas Law (Texas Charitable Immunity and Liability Act of 1987 [as amended]), as well as Federal Law (Volunteer Protection Act of 1997), provides IMMUNITY FROM CIVIL LIABILITY for any act or omission resulting in death, damage, or injury if the volunteer was acting in good faith and in the course of his/her duties or functions within the organization.
By signing below, you acknowledge: (1) that the Clinic’s volunteer healthcare providers (such as physicians, physician assistants, registered nurses, licensed vocational nurses, pharmacists, podiatrists, dentists, dental hygienists, optometrists, or any such persons who are retired or otherwise defined or included under Texas law or Federal law) are providing health care that is not administered for or in expectation of compensation; and (2) that there are limitations on you or your family’s ability to recover damages from the volunteer or the Bethesda Health Clinic in exchange for your receiving health care services.
It is intended that this WAIVER be as broad and expansive as allowed by law.
By clicking the Submit button below, I hereby declare that the above information is true and correct and that I have read and agree to the Waiver of Liability for Treatment. I know that any false information could jeopardize my eligibility to receive medical and/or dental attention at Bethesda Health Clinic.