Common Contracts
1 similar Financial Policy Agreement contracts
Print, complete and bring to appointmentFinancial Policy Agreement • February 6th, 2010
Purpose: This is an agreement between the St. Petersburg Dental Center, and the named patient and responsible party on this form. We appreciate you choosing us for your dental needs and we want to be sure you fully understand your financial obligations for the services we will be providing. By signing this agreement, you are agreeing to Pay for all services rendered.
