Common Contracts
2 similar Financial Responsibility Agreement contracts
FINANCIAL RESPONSIBILITY AGREEMENT SELF PAY or NON-APPROVED HOSPITAL SERVICESFinancial Responsibility Agreement • October 20th, 2021
The Lindner Center of HOPE (LCOH) appreciates the confidence you have shown in choosing us to provide health care services to you or a patient for whom you have responsibility. Our patient and family-centered treatment philosophy requires that we openly communicate our policies and expectations about payment for our services before treatment is initiated. Please take a moment to familiarize yourself with these policies.
FINANCIAL RESPONSIBILITY AGREEMENT SELF PAY or NON-APPROVED HOSPITAL SERVICESFinancial Responsibility Agreement • June 30th, 2021
The Lindner Center of HOPE (LCOH) appreciates the confidence you have shown in choosing us to provide health care services to you or a patient for whom you have responsibility. Our patient and family-centered treatment philosophy requires that we openly communicate our policies and expectations about payment for our services before treatment is initiated. Please take a moment to familiarize yourself with these policies.
