Common Contracts
1 similar Patient Responsibility Agreement contracts
PATIENT RESPONSIBILITY AGREEMENT and INSURANCE POLICYPatient Responsibility Agreement • February 19th, 2019
We would like to take this opportunity to Welcome you to our practice and assure you that we will do our utmost to provide you or your child with the best possible care. The following is a statement of our Financial Policy, which we require that you read, agree to and sign prior to you/your child’s first visit.
