Common Contracts

1 similar null contracts

Ph: 214-216-6564 Fax: 214-385-2574 Patient Financial Responsibility Agreement
June 17th, 2023
  • Filed
    June 17th, 2023

I, ______________________________________________________, understand and agree to the following financial responsibilities associated with the medical services provided by Texas Gastroenterology Center PLLC (Dr Muhammad Osman Arif) and/or Texas Arthritis and Rheumatology PLLC (Dr Zainab Shahnawaz).

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