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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 19A
for the current year.
Form 19A Section 19a Medical Mediation Agreement - Massachusetts
What Is Form 19A?
This is a legal form that was released by the Massachusetts Department of Industrial Accidents - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 19A Section 19a?
A: Form 19A Section 19a is a medical mediation agreement used in Massachusetts.
Q: What is the purpose of Form 19A Section 19a?
A: The purpose of Form 19A Section 19a is to establish an agreement between parties involved in a medical dispute to pursue mediation.
Q: Who is involved in Form 19A Section 19a?
A: The parties involved in Form 19A Section 19a typically include the patient, the patient's representative, the health care provider, and any relevant insurance company.
Q: What does Form 19A Section 19a cover?
A: Form 19A Section 19a covers the details of the mediation process, confidentiality agreements, and the responsibilities of each party.
Q: When should Form 19A Section 19a be used?
A: Form 19A Section 19a should be used when the parties involved in a medical dispute wish to pursue mediation as an alternative to a formal legal process.
Q: Is Form 19A Section 19a legally binding?
A: Form 19A Section 19a is a legally binding agreement once signed by all parties involved.
Q: Can Form 19A Section 19a be used in other states?
A: Form 19A Section 19a is specific to Massachusetts and may not be applicable or recognized in other states.
Form Details:
- Released on December 1, 2016;
- The latest edition provided by the Massachusetts Department of Industrial Accidents;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 19A by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Industrial Accidents.
