LEGAL RELATIONSHIP BETWEEN HOSPITAL AND PHYSICIANS/PROVIDERS: Massac Memorial Hospital employs Jonathan Walters, MD; Adam Connell, MD; Michael Hicks, MD; Thomas Staton, MD; Yusheng Dong, MD; Mallory Wittig, APRN, FNP-BC; Alyce Hannan APRN, FNP-BC; Amanda Reed, APRN, ACNS-BC; Ashley Hagerty, PA-C; Ashley Suggs, APRN, FNP-C, and Jessica Wright, APRN, FNP-C. All other physicians/providers, pathologists, radiologists, anesthesia providers, other hospital-based providers, my attending physician/provider and consulting physicians/providers are independent contractors and are NOT employees or agents of Massac Memorial Hospital. All such physicians/providers are independent contractors who have been granted privileges at this facility for care and treatment of their patients. I recognize that the independent contractor physicians/providers are not subject to supervision or control of Massac Memorial Hospital with respect to my treatment. I acknowledge that the employment agency status of physicians/providers participating in my care are not relevant to my selection of Massac Memorial Hospital/Massac Memorial Medical Clinics for my care. I acknowledge that any questions about the Independent Contractor Disclosure paragraph and the important information contained in it have been answered to my satisfaction.
