急診留觀患者監(jiān)護制度

急診留觀患者監(jiān)護制度合同編號：__________甲方：__________乙方：__________鑒于甲方為一家具有醫(yī)療資質(zhì)的醫(yī)療機構(gòu)，乙方為前來甲方急診留觀的患者或其法定代理人，為規(guī)范甲方對乙方在急診留觀期間提供的監(jiān)護服務(wù)，雙方經(jīng)友好協(xié)商，就甲方提供監(jiān)護服務(wù)相關(guān)事宜達成如下協(xié)議：一、甲方提供的監(jiān)護服務(wù)內(nèi)容：1.1對乙方在急診留觀期間進行全面觀察，監(jiān)測乙方生命體征及病情變化；1.2安排醫(yī)護人員對乙方進行定期查房，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如實向甲方提供乙方健康狀況、既往病史、藥物過敏史等個人信息；2.2遵守甲方規(guī)章制度，配合甲方醫(yī)護人員進行診療；2.3按約定時間支付監(jiān)護服務(wù)費用。三、監(jiān)護服務(wù)費用及支付方式：3.1乙方向甲方支付的監(jiān)護服務(wù)費用為人民幣____元整（大寫：____________________元整）；3.2乙方應(yīng)按照甲方規(guī)定的支付方式及時支付監(jiān)護服務(wù)費用；3.3甲方提供監(jiān)護服務(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)，并按照實際發(fā)生費用結(jié)算。四、違約責任：4.1任何一方違反本協(xié)議的約定，導致合同無法履行或造成對方損失的，應(yīng)承擔違約責任，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)護服務(wù)，乙方有權(quán)要求甲方退還已支付的監(jiān)護服務(wù)費用；4.3乙方未按約定時間支付監(jiān)護服務(wù)費用，甲方有權(quán)終止提供監(jiān)護服務(wù)，并要求乙方支付逾期付款違約金。五、爭議解決：5.1雙方在履行本協(xié)議過程中發(fā)生的爭議，應(yīng)通過友好協(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____年，自協(xié)議生效之日起計算；6.3本協(xié)議未盡事宜，可由雙方另行簽訂補充協(xié)議，補充協(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（或負責人）：__________法定代表人（或負責人）：__________簽訂日期：__________簽訂日期：___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________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