Common Contracts
1 similar Credit Card on File Agreement contracts
Credit Card on File AgreementCredit Card on File Agreement • January 28th, 2022
o I, authorize Moore Foot & Ankle Specialists, PA to charge my credit card for the following reasons: Co-pays or co-insurance, cancel or no-show fees, self-pay items not covered by insurance, and any other item and/or service that I give verbal or written permission for.
