Common Contracts
3 similar Financial Policy Agreement contracts
ContractFinancial Policy Agreement • July 6th, 2022
At Dermatology San Antonio, we believe that all patients who are rendered care at this office deserve the best medical care that can be provided. We provide you with the Agreement regarding our financial policy and your agreement to pay for services provided so that you are aware of our policies and procedures up front. We require each patient to sign and date this Agreement on the last page to indicate you accept these terms.
acc# ________________ Diplomats of the American Board of Dermatology General, Surgical and Cosmetic DermatologyFinancial Policy Agreement • May 26th, 2022
At Dermatology San Antonio, we believe that all patients who are rendered care at this office deserve the best medical care that can be provided. We provide you with the Agreement regarding our financial policy and your agreement to pay for services provided so that you are aware of our policies and procedures up front. We require each patient to sign and date this Agreement on the last page to indicate you accept these terms.
ContractFinancial Policy Agreement • August 4th, 2020
At Dermatology San Antonio, we believe that all patients who are rendered care at this office deserve the best medical care that can be provided. We provide you with the Agreement regarding our financial policy and your agreement to pay for services provided so that you are aware of our policies and procedures up front. We require each patient to sign and date this Agreement on the last page to indicate you accept these terms.
