Common Contracts
1 similar Financial Agreement contracts
FINANCIAL AGREEMENTFinancial Agreement • January 2nd, 2020
By signing below I fully understand the doctor’s recommendations and understand the financial obligation of co-pay and deductible (if any), in addition charges for services will be billed directly to my insurance company. Some patients might receive the physical check at their residence and are responsible for turning over to Pain and Wellness of Arizona for services rendered.
