Common Contracts
2 similar Fee Agreement contracts
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement • November 4th, 2020
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees for Karen Muehl Counseling, PLLC (“KMC”). Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
FEE AGREEMENT AND FINANCIAL POLICYFee Agreement • October 21st, 2020
Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes my schedule of fees for therapy services, charges not covered by insurance, and additional fees for Karen Muehl Counseling, PLLC (“KMC”). Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask me prior to signing this Agreement and Policy.
