Common Contracts

Installment Payment Agreement

Installment Payment Agreement • January 21st, 2014

• Contract Type
  Installment Payment Agreement
• Filed
  January 21st, 2014

 I, , give consent to Southwest Allergy and Asthma Center to retain my credit/debit card information on file until the debt addressed in this agreement is paid in full. I understand that if at any time the card should become inactive or reach its printed expiration date, I will notify Southwest Allergy and Asthma Center within 10 days and provide an alternative means of payment.