Common Contracts
1 similar Financial Policy contracts
This is an agreement between the office of Aaron C. Polk, D.D.S. Dentistry and the Patient/Debtor named on this form.Financial Policy • November 19th, 2020
In this agreement, the words “you,” “your,” and “yours” mean the Patient/Debtor. The word “account” means the account that has been established in your name to which charges are made and payments are credited. The words “we,” “us,” and “our” refers to the office of Aaron C. Polk, D.D.S. Dentistry. By executing this agreement, you are agreeing to pay for all services that are received.
