Common Contracts
1 similar null contracts
Date of Birth: / /April 4th, 2019
This is an agreement between North Lakes Pain Consultants (NLPC), as creditor, and the Patient/Debtor named on this form. 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 credited. The words “we,” “us” and “our” refer to NLPC. By executing this agreement, you are agreeing to pay for all services rendered.
