Common Contracts
2 similar Financial Policy contracts
Financial PolicyFinancial Policy • September 13th, 2019
Terms: This is an agreement between Gunderson Eyecare, P.C., as creditor, and the Patient/and Responsible Party named on this form, as debtor. In this agreement the words “you, your, and yours” mean the Patient/and Responsible Party. The word “account” means the account that has been established in patients or responsible party’s name to which charges are made and payments credited. The words “we, us, and our” refer to Gunderson Eyecare, P.C. By executing this agreement, you are agreeing to pay for all services that are received.
Standard Contracts
Financial PolicyFinancial Policy • May 20th, 2011
Terms: This is an agreement between Gunderson Eyecare, P.C., as creditor, and the Patient/and Responsible Party named on this form, as debtor. In this agreement the words “you, your, and yours” mean the Patient/and Responsible Party. The word “account” means the account that has been established in patient’s or responsible party’s name to which charges are made and payments credited. The words “we, us, and our” refer to Gunderson Eyecare, P.C. By executing this agreement, you are agreeing to pay for all services that are received.
