Common Contracts

1 similar Financial Agreement contracts

FINANCIAL AGREEMENT 2022
Financial Agreement • December 2nd, 2021

Thank you for trusting Advanced Interventional Pain Consultants to partner in your health care. This financial agreement should answer questions regarding patient and insurance responsibility for services rendered. Please read this agreement, ask us any questions you may have, and sign in the space provided. If required, you will be given a copy of this agreement for your records.

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