C-26, r. 161 - Regulation respecting the procedure for conciliation and arbitration of accounts of nursing assistants

Schedule Disposition versions

2016-01-01

SCHEDULE 2

(s. 3.01.01)

SUBMISSION TO ARBITRATION

Entered into by:

---

(name and address)

in person or (where applicable) representing ______________________________ for the purposes of this submission, as attested by the authorization annexed hereto, hereinafter referred to as “the party of the first part”, and

---

(name and address)

member of the Ordre des infirmières et infirmiers auxiliaires du Québec, hereinafter referred to as “the party of the second part”, who make the following declarations and agreements:

(1) The party of the second part claims from the party of the first part the sum of __________ for professional services rendered between ______________________________ and ______________________________, as attested by the account a copy of which is annexed hereto;

(2) The party of the first part

Check the appropriate box

(a) refuses to pay this account □

or

(b) asks for a reimbursement of $ __________ □

for the following reasons:

---

---

---

For the purposes of prescription, the party of the first part waives the benefit of elapsed time;

(3) The dispute between the parties bears on the entire account or (where applicable) on that part of the account which exceeds that which the party of the first part acknowledges that he owes to the party of the second part, namely, the sum of __________;

(4) The dispute between the parties will be settled by arbitration held in accordance with Division III of the Regulation respecting the procedure for conciliation and arbitration of accounts of nursing assistants (chapter C-26, r. 161), of which the parties declare having received a copy and taken cognizance;

(5) The party of the second part undertakes, for the duration of the arbitration, not to claim before the civil courts that part of the account which is the object of the dispute.

The party of the first part undertakes, for the duration of the arbitration, not to claim, before civil courts, reimbursement of the amount it paid towards all or part of the account in dispute;

(6) The arbitration award is binding upon the parties and the rules set forth in Title II of Book VII of the Code of Civil Procedure (chapter C-25.01) apply to its enforcement;

(7) This submission may be annulled only with the written consent of the parties.

---

(signature of patient or his duly authorized representative)

Signed at ____________________________________________________________________________

this ____________________________________________________________________ 20_________

---

(signature of professional)

Signed at ____________________________________________________________________________

this ____________________________________________________________________ 20_________

R.R.Q., 1981, c. C-26, r. 117, Sch. 2; O.C. 1079-96, ss. 6 and 7; I.N. 2016-01-01 (NCCP).

2012-09-01

SCHEDULE 2

(s. 3.01.01)

SUBMISSION TO ARBITRATION

Entered into by:

---

(name and address)

in person or (where applicable) representing ______________________________ for the purposes of this submission, as attested by the authorization annexed hereto, hereinafter referred to as “the party of the first part”, and

---

(name and address)

member of the Ordre des infirmières et infirmiers auxiliaires du Québec, hereinafter referred to as “the party of the second part”, who make the following declarations and agreements:

(1) The party of the second part claims from the party of the first part the sum of __________ for professional services rendered between ______________________________ and ______________________________, as attested by the account a copy of which is annexed hereto;

(2) The party of the first part

Check the appropriate box

(a) refuses to pay this account □

or

(b) asks for a reimbursement of $ __________ □

for the following reasons:

---

---

---

For the purposes of prescription, the party of the first part waives the benefit of elapsed time;

(3) The dispute between the parties bears on the entire account or (where applicable) on that part of the account which exceeds that which the party of the first part acknowledges that he owes to the party of the second part, namely, the sum of __________;

(4) The dispute between the parties will be settled by arbitration held in accordance with Division III of the Regulation respecting the procedure for conciliation and arbitration of accounts of nursing assistants (chapter C-26, r. 161), of which the parties declare having received a copy and taken cognizance;

(5) The party of the second part undertakes, for the duration of the arbitration, not to claim before the civil courts that part of the account which is the object of the dispute.

The party of the first part undertakes, for the duration of the arbitration, not to claim, before civil courts, reimbursement of the amount it paid towards all or part of the account in dispute;

(6) The arbitration award is binding upon the parties and the rules set forth in Book VII of the Code of Civil Procedure (chapter C-25) apply to its enforcement;

(7) This submission may be annulled only with the written consent of the parties.

---

(signature of patient or his duly authorized representative)

Signed at ____________________________________________________________________________

this ____________________________________________________________________ 20_________

---

(signature of professional)

Signed at ____________________________________________________________________________

this ____________________________________________________________________ 20_________

R.R.Q., 1981, c. C-26, r. 117, Sch. 2; O.C. 1079-96, ss. 6 and 7.