急診留觀患者監(jiān)護(hù)制度

急診留觀患者監(jiān)護(hù)制度合同編號(hào)：__________甲方：__________乙方：__________鑒于甲方為一家具有醫(yī)療資質(zhì)的醫(yī)療機(jī)構(gòu)，乙方為前來(lái)甲方急診留觀的患者或其法定代理人，為規(guī)范甲方對(duì)乙方在急診留觀期間提供的監(jiān)護(hù)服務(wù)，雙方經(jīng)友好協(xié)商，就甲方提供監(jiān)護(hù)服務(wù)相關(guān)事宜達(dá)成如下協(xié)議：一、甲方提供的監(jiān)護(hù)服務(wù)內(nèi)容：1.1對(duì)乙方在急診留觀期間進(jìn)行全面觀察，監(jiān)測(cè)乙方生命體征及病情變化；1.2安排醫(yī)護(hù)人員對(duì)乙方進(jìn)行定期查房，并根據(jù)乙方病情調(diào)整治療方案；1.3如有必要，甲方應(yīng)及時(shí)通知乙方或其法定代理人并采取相應(yīng)救治措施；1.4確保乙方在急診留觀期間的安全，防止意外事故發(fā)生。二、乙方義務(wù)：2.1如實(shí)向甲方提供乙方健康狀況、既往病史、藥物過(guò)敏史等個(gè)人信息；2.2遵守甲方規(guī)章制度，配合甲方醫(yī)護(hù)人員進(jìn)行診療；2.3按約定時(shí)間支付監(jiān)護(hù)服務(wù)費(fèi)用。三、監(jiān)護(hù)服務(wù)費(fèi)用及支付方式：3.1乙方向甲方支付的監(jiān)護(hù)服務(wù)費(fèi)用為人民幣_(tái)___元整（大寫(xiě)：____________________元整）；3.2乙方應(yīng)按照甲方規(guī)定的支付方式及時(shí)支付監(jiān)護(hù)服務(wù)費(fèi)用；3.3甲方提供監(jiān)護(hù)服務(wù)期間，如乙方病情惡化需轉(zhuǎn)院治療，甲方應(yīng)協(xié)助乙方辦理相關(guān)手續(xù)，并按照實(shí)際發(fā)生費(fèi)用結(jié)算。四、違約責(zé)任：4.1任何一方違反本協(xié)議的約定，導(dǎo)致合同無(wú)法履行或造成對(duì)方損失的，應(yīng)承擔(dān)違約責(zé)任，向?qū)Ψ街Ц哆`約金，并賠償損失；4.2甲方未按約定提供監(jiān)護(hù)服務(wù)，乙方有權(quán)要求甲方退還已支付的監(jiān)護(hù)服務(wù)費(fèi)用；4.3乙方未按約定時(shí)間支付監(jiān)護(hù)服務(wù)費(fèi)用，甲方有權(quán)終止提供監(jiān)護(hù)服務(wù)，并要求乙方支付逾期付款違約金。五、爭(zhēng)議解決：5.1雙方在履行本協(xié)議過(guò)程中發(fā)生的爭(zhēng)議，應(yīng)通過(guò)友好協(xié)商解決；5.2若協(xié)商不成，任何一方均有權(quán)向甲方所在地的人民法院提起訴訟。六、其他約定：6.1本協(xié)議一式兩份，甲乙雙方各執(zhí)一份；6.2本協(xié)議自雙方簽字（或蓋章）之日起生效，有效期為_(kāi)___年，自協(xié)議生效之日起計(jì)算；6.3本協(xié)議未盡事宜，可由雙方另行簽訂補(bǔ)充協(xié)議，補(bǔ)充協(xié)議與本協(xié)議具有同等法律效力。甲方（蓋章）：__________乙方（簽字/蓋章）：__________法定代表人（或負(fù)責(zé)人）：__________法定代表人（或負(fù)責(zé)人）：__________簽訂日期：__________簽訂日期：___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________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