The lien claimant, at any time after the rendering of the hospital services, or some part thereof, or from time to time as the services are rendered, as the lien claimant may deem best, but not later than thirty days after the services have been rendered and terminated, shall file a lien statement in the office of the clerk of the district court of the county in which the services were rendered containing all of the following: 1. The name of the injured person to whom the services were rendered. 2. The address of the injured person as shown upon the records of the hospital or institution. 3. The date upon which the injured person was admitted to the hospital and the date of that person's release, if that person has been released from the hospital at the time of the filing of the statement. 4. The name, if known, of the person, corporation, or limited liability company alleged or claimed to be guilty of the negligence causing the injuries, and the address, if known, or ascertainable from the hospital records. 5. The name and address of any person, corporation, or limited liability company insuring the tort -feasor against liability on account of negligence, if the same are known or ascertainable from the hospital records. 6. The name of any insurer liable for insurance to the injured person, if known. 7. An itemized statement of the charges for hospital services and the total sum claimed to be due. Such statement must be signed in the name of the hospital or institution claiming the lien and verified on behalf of the institution by some person authorized so to do and possessing knowledge of the facts. The verification must show that the facts therein set forth are true to the best of the knowledge, information, and belief of the person making the same, that the charges for services are the reasonable and usual charges of the institution for such services, and that the sum claimed is due and unpaid.
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