Common Contracts
1 similar Financial Policy and Patient Agreement contracts
FINANCIAL POLICY AND PATIENT AGREEMENTFinancial Policy and Patient Agreement • June 11th, 2024
PAYMENT IS EXPECTED AT THE TIME OF SERVICE FOR THE PATIENT’S PORTION OF THE CHARGES. WE ACCEPT CASH, CHECKS, AND MOST MAJOR CREDIT CARDS FOR YOUR CONVENIENCE. WE REQUIRE YOU TO READ THE FINANCIAL POLICY AND THE SURPRISE BILLING ACT ENTIRELY AND SIGN BEFORE TREATMENT.
