Common Contracts
3 similar Installment Agreement contracts
Installment agreement for patients between 25% to 49% above ideal body weightInstallment Agreement • January 18th, 2016 • Kentucky
This Installment Agreement (the “Agreement”) is made and entered into by and between Dr. Richard Levin, M.D., PSC (“Doctor”) and the patient (“Patient”) and significant other (“Other”) identified, listed and signed at the end of this agreement on the date indicated (“Date”) at the end of this Agreement by Patient and Other.
Installment agreement for patients between 50% to 74% above ideal body weightInstallment Agreement • January 18th, 2016 • Kentucky
This Installment Agreement (the “Agreement”) is made and entered into by and between Dr. Richard Levin, M.D., PSC (“Doctor”) and the patient (“Patient”) and significant other (“Other”) identified, listed and signed at the end of this agreement on the date indicated (“Date”) at the end of this Agreement by Patient and Other.
Installment agreement for patients who are less than 25% above ideal body weightInstallment Agreement • January 18th, 2016 • Kentucky
This Installment Agreement (the “Agreement”) is made and entered into by and between Dr. Richard Levin, M.D., PSC (“Doctor”) and the patient (“Patient”) and significant other (“Other”) identified, listed and signed at the end of this agreement on the date indicated (“Date”) at the end of this Agreement by Patient and Other.
