Charges to Account. We shall have the right to cancel your privilege to make charges against your account at any time. Future visits would then need to be paid at the time of service.
Charges to Account. We shall reserve the right to cancel your privilege to make charges against your account at any time. Future visits would then need to be paid at time of service. Past due accounts: If your account becomes past due, we will take the necessary steps to collect this debt. If we have to refer your account to a collection agency, you agree to pay all the collection costs which are incurred (not to exceed 33%). If we have to refer collection to a lawyer, you agree to pay all lawyer fees which we incur plus all court costs. In case of suit, you agree the venue shall be in Xxxxxxxxxx County, Maryland. Waiver of confidentiality: You understand that if this account is submitted to an attorney or collection agency, if we have to litigate in court, or if your past due status is reported to the credit reporting agency, the fact that you received services from our office may become a matter of public record. Transferring of Records: You will need to request in writing and pay a copying fee if you want to have copies of your records sent to you, your doctor, or any other organization. If you are requesting your records to be transferred from another doctor or any other organization to us, you authorize us to receive all relevant information. Effective Date: Once you have signed this agreement, you agree to all of the terms and conditions contained herein and the agreement will be in full force and effect. Patient Name: Patient Signature: Date:
Examples of Charges to Account in a sentence
Charges to Account: We shall have the right to cancel your privilege to make charges against your account at any time.
Charges to Account: If arrangements are made in advance of treatment we will allow charges to be placed on your account.