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Common Contracts

1 similar Financial Agreement contracts

Jeffrey M. Eisner, D.M.D., P.A. Financial Agreement
Financial Agreement • May 7th, 2012

Welcome 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.

Standard Contracts