PAYMENT FOR SERVICES AGREEMENTPayment for Services Agreement • November 11th, 2022
Dr. Feinberg uses “Ivy Pay” for payment of services which is specifically designed for therapists and is HIPAA-compliant. Prior to your initial appointment Ivy Pay will text you a secure link to your phone leading to a page where you enter your credit card information and approve the first charge. This is not spam. Please open the text and follow the steps. A deposit of $100 will be used to secure your initial appointment. If it is not received 72 hours prior to your scheduled appointment your time slot will be cancelled. IVY Pay works with your debit card, credit card, HSA or FSA account. It is HIPAA secure and it keeps our therapeutic relationship confidential. You will only have to enter your information one time. Just like the current system, once you enter in your information it will be securely saved and after your appointment a superbill/receipt will be handed to you if your appointment is in the office or emailed if it was virtual.
Suzanne P. Triemstra, DDS, PLLC 1613 Military Cutoff Rd. Ste: 220Payment for Services Agreement • March 21st, 2024
EXHIBIT 10.4 NEW CONCEPT MINING, INC. 1017 S. Mountain Ave. Monrovia, California 91016 (626) 357-5000 FAX (626) 357-4464 November 12, 1999 Dr. Frank Lucas Loeb Aron & Company Ltd. Georgian House 63, Coleman Street London EC2R 5BB UNITED KINGDOM RE:...Payment for Services Agreement • December 6th, 1999 • American Technologies Group Inc • Wholesale-motor vehicles & motor vehicle parts & supplies
This will confirm the agreement of New Concept and Loeb Aron that in consideration of the services of Loeb Aron in trying to locate a buyer for New Concept's Tempiute tungsten New Concept shall deliver to Loeb Aron 30,000 shares of American Technologies Group, Inc. stock. The shares shall be registered on Form S-8.
Payment for Services AgreementPayment for Services Agreement • November 13th, 2019
We at Drs. Schwartzman, Healy and Offit are committed to providing all of our patients with exceptional care. As a result, our fees are based on a combination of our costs, our time and our constant dedication to providing our patients with the highest quality dental care. This Payment for Services Agreement explains your responsibilities for payment for the services we provide to you or to someone for whom you are financially responsible.
Payment for Services AgreementPayment for Services Agreement • February 25th, 2020
Thank you for choosing NCATP to provide your Augmentative Communication/Assistive Technology (AT) services. We are committed to providing the best services possible. Please review this entire policy before signing. If you have ANY questions, please contact the NCATP Intake Coordinator at 919-855-3613 and we would be happy to speak with you.
