III. Assignment and/or Lien for Medical Services.
Patient understands that the medical services, supplies and treatment Patient is receiving as a part of the ongoing personal injury claim shall be billed as a lien, as authorized by applicable state law and practice. Patient hereby irrevocably authorizes and directs Attorney, to pay directly to Texas Regional Center, such sums due and owing for services rendered to Patient by reason of the accident from which the claim arises, and by reason of any other bills that are due to Texas Regional Center, and to withhold such sums from any claim, settlement, judgement or verdict as may be necessary to adequately protect and clear Patient’s account with Texas Regional Center prior to and before any fees are paid to Attorney out of said settlement. By this assignment, Patient gives this Lien on Patient’s claim to Texas Regional Center against any and all proceeds of any settlement, judgement or verdict that may be paid to Attorney, or Patient or to another individual on Patient’s behalf, that results from the injuries or injuries and illnesses in connection thereto, for which Patient has been treated. If Patient assigns any or all of the Patient’s rights to his or her claim or a portion thereof, Patient agrees to notify Texas Regional Center, in writing, at the below address within thirty (30) days from the date of assignment. If another attorney is substituted in this matter, the new attorney shall honor this Lien as inherent to Patient’s claim, and notice of, and substitution of, this Lien shall be both Patient and Attorney’s responsibility.