Common Contracts

1 similar Patient Financial Responsibility Agreement contracts

Patient Financial Responsibility Agreement
Patient Financial Responsibility Agreement • August 3rd, 2020

We value the relationship we have with you and your children. Advising you in advance of our office policy for financial obligations allows for a good flow of communication. Please read and sign this agreement. If there are questions regarding any of this content, please do not hesitate to ask a member of our billing team.

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