Common Contracts
1 similar Financial Policy contracts
Scott W. Berneburg, DPM, Inc. (dba Beckley Foot & Ankle Clinic)Financial Policy • August 6th, 2018
This is an agreement between Scott W. Berneburg, DPM, Inc. (dba Beckley Foot & Ankle Clinic) and the Patient/Responsible Party named on this form. By executing this agreement, you are agreeing to pay for all services that are received.
