Credit Card on File AgreementOn File Agreement • October 25th, 2021
Contract Type FiledOctober 25th, 2021o I, authorize Moore Foot & Ankle Specialists, PA to charge my credit card for the following reasons: Co-pays or co-insurance, cancel or no-show fees, self-pay items not covered by insurance, and any other item and/or service that I give verbal or written permission for.