Pay as You Go Treatment Agreement Sample Contracts

Terms and Conditions of Tycoch Dental Centre Pay As You Go
Pay as You Go Treatment Agreement • September 11th, 2021

The purpose of this document is to set out the terms of the agreement for treatment between the person signing this document and the dental practice (Tycoch Dental Centre). This document details the treatment to which the patient is entitled to and the patient’s obligations to the dental practice under the scheme. This document has been designed to clearly explain the operation of the scheme to the Payer. However, if you have any questions about the scheme, please do not hesitate to discuss them with us and we will only be too pleased to advise you, before signing this agreement. Please read the terms and conditions set out below very carefully and if you are happy to proceed, sign the agreement form and return it to the dental practice. An additional copy of the agreement is available upon request. By signing a copy of this agreement you are agreeing to be bound by the terms and conditions contained in it.

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