Dental Health AgreementDental Health Agreement • October 27th, 2015
Contract Type FiledOctober 27th, 2015Thank you for selecting our office for your dental care. We are committed to the success of your treatment. Please understand that payment of your bill is considered a part of your commitment to treatment.
Dental Health AgreementDental Health Agreement • June 9th, 2021
Contract Type FiledJune 9th, 2021Thank you for selecting our office for your dental care. We are committed to the success of your treatment. Please understand that payment of your bill is considered a part of your commitment to treatment. In order to be impartial to everyone, WE REQUIRE PAYMENT AT TIME OF TREATMENT. We ask that you read and sign this statement prior to any treatment. YOUR PATIENT PORTION IS DUE IN FULL AT THE TIME OF THE TREATMENT. For extensive treatment plans, we offer extended payment plans with an outside financial institution at either little or NO interest with prior credit approval.