Common Contracts

1 similar Fee Agreement and Financial Policy contracts

FEE AGREEMENT AND FINANCIAL POLICY
Fee Agreement and Financial Policy • April 25th, 2015

Thank you for choosing The Rock Counseling Group. Please review this Fee Agreement and Financial Policy (the “Agreement and Policy”), which describes our schedule of fees for services, charges not covered by insurance, and additional fees. Please be sure you understand the policies regarding cancelations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions about anything, please ask your provider prior to signing this Agreement and Policy.