Common Contracts
1 similar Fee Agreement contracts
Christine Wilkes, Psy.D.Fee Agreement • January 29th, 2022
PLEASE REVIEW FEE AGREEMENT CAREFULLY: I understand that payment is due in full at the beginning of the evaluation process. I understand that my insurance may not pay for Dr. Wilkes’ services and I agree to pay for the services, regardless of what insurance pays. I authorize the release of any information necessary to process the claim with my insurance. I agree to notify Dr. Wilkes of any changes in my insurance coverage.
