Common Contracts
1 similar Discount Fee Application & Agreement contracts
Discount Fee Application & AgreementDiscount Fee Application & Agreement • November 14th, 2017
Premier Community Healthcare Group Inc provides essential services regardless of the patient’s ability to pay. Discounts are offered depending upon household/family income and size. A “Family” is one or more persons living in one dwelling place who are related by blood, marriage or law. A “Dependent” is someone who lives in your household and qualifies as a dependent for federal tax purposes. Please list information below to determine if you or your family members are eligible for our discounted fees program. Once your Discount Fee Plan is determined, payment is due at time of service.
