We use cookies on our site to analyze traffic, enhance your experience, and provide you with tailored content.
For more information visit our privacy policy.Jeffrey M. Eisner, D.M.D., P.A. Financial AgreementFinancial Agreement • May 7th, 2012
Contract Type FiledMay 7th, 2012Welcome to our office. As our health care system has changed, there has been some confusion regarding financial responsibility of the patient for medical/dental treatment. This form is intended to clarify your responsibilities as our financial policy is based on an open and honest discussion of fees.