Finance Policy Agreement Sample Contracts

FINANCE POLICY AGREEMENT (with CHP+)
Finance Policy Agreement • February 18th, 2024

The CarePoint Anesthesia Group LLC, hereinafter known as (“CarePoint”), is dedicated to providing specialized anesthesia services to the familiar and comfortable environment of your dentist’s office, bringing a tailored and personal touch to your child’s care. We would like to advise you of your financial obligations. Please initial below that you have read, understood, and acknowledge this Finance Policy Agreement.

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FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • March 28th, 2022
FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • March 20th, 2024
FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • July 28th, 2021
FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • March 8th, 2023
FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • July 28th, 2021
FINANCE POLICY & AGREEMENT FORM
Finance Policy & Agreement • March 8th, 2022
FINANCE POLICY AGREEMENT
Finance Policy Agreement • January 18th, 2024

The CarePoint Dental Anesthesia Group of Michigan, herein after known as “CarePoint”, is dedicated to providing specialized anesthesia services to the familiar and comfortable environment of your dentist’s office, bringing a tailored and personal touch to your child’s care. We would like to advise you of your financial obligations. Please initial below that you have read, understood, and acknowledge this Finance Policy Agreement.

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