Discount Fee Application & Agreement Sample Contracts

Discount Fee Application & Agreement
Discount Fee Application & Agreement • November 14th, 2017

Premier Community Healthcare Group Inc provides essential services regardless of the patient’s ability to pay. Discounts are offered depending upon household/family income and size. A “Family” is one or more persons living in one dwelling place who are related by blood, marriage or law. A “Dependent” is someone who lives in your household and qualifies as a dependent for federal tax purposes. Please list information below to determine if you or your family members are eligible for our discounted fees program. Once your Discount Fee Plan is determined, payment is due at time of service.

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PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Discount Fee Application & Agreement • December 12th, 2019

Premier Community Healthcare Group Inc provides essential services regardless of the patient’s ability to pay. Discounts are offered depending upon household size and income. Household size is defined as an individual or group of two or more people living in one dwelling who share expenses and living cost. Income is defined as the sum of income, before taxes and deductions, available to the household at the time of application.

Discount Fee Application & Agreement
Discount Fee Application & Agreement • October 11th, 2018

Premier Community Healthcare Group Inc provides essential services regardless of the patient’s ability to pay. Discounts are offered depending upon household/family income and size. A “Family” is one or more persons living in one dwelling place who are related by blood, marriage or law. A “Dependent” is someone who lives in your household and qualifies as a dependent for federal tax purposes. Please list information below to determine if you or your family members are eligible for our discounted fees program. Once your Discount Fee Plan is determined, payment is due at time of service.

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