Client/Responsible Party Agreement for Payment of Services Sample Contracts

o Client/Responsible Party Agreement for Payment of Services

Client/Responsible Party Agreement for Payment of Services • December 13th, 2016

• Contract Type
  Client/Responsible Party Agreement for Payment of Services
• Filed
  December 13th, 2016

o This form MUST be signed and returned prior to the first visit. If you choose to place a credit card on file, you may choose to have that card charged weekly or monthly. A receipt will be mailed to you after each charge.