File AgreementFile Agreement • May 5th, 2020
This File Agreement is between (“you” or “your”), and Dewberry Consultants LLC (“we,” “our,” and “us”), a Virginia limited liability company, for the Allder School Road (CPAR-2016-0011/CPAP-2011-0065) project.
CREDIT CARD ON FILE AGREEMENTFile Agreement • March 31st, 2014
We have an optional system allowing us to maintain your Credit Card information securely on file which would be accessed only under the terms you specify below. This is completely optional and for your convenience regarding payment of services rendered.
Exhibit 8 File Agreement dated October 20, 2000 Regarding Joint Filing of Schedule 13D The undersigned hereby agree that: (1) Each of them is individually eligible to use the Schedule 13D attached hereto; (2) The attached Schedule 13D is filed on...File Agreement • October 20th, 2000 • Herman Stephen C • Services-business services, nec
Credit Card On File AgreementFile Agreement • September 9th, 2021
We have implemented a policy which enables you to maintain your credit card information securely on file with Richmond Creative Counseling (RCC). In providing us with your credit card information, you are giving RCC permission to automatically charge your credit card on file for your (or any other patient(s) you have listed on this form) co-pays/co-insurance, outstanding balances, services, and/or products.
Credit Card on File AgreementFile Agreement • January 17th, 2011
As an authorized signer on the credit card listed below, I give Psychological Counseling Services, Ltd. permission to utilize the credit card for all charges related to and including services rendered at PCS.
Credit Card On File AgreementFile Agreement • June 18th, 2020
We have implemented a policy which enables you to maintain your credit card information securely on file with Northwest Counseling, Inc. In providing us with your credit card information, you are giving NCI permission to automatically charge this card for any outstanding balance due for you or your dependents.
South Hills Integrated Psychiatric Services, P.C.File Agreement • January 30th, 2015
This agreement is required- if you chose to decline this authorization or do not maintain a valid and current credit card on file, billing and unpaid balance fees, and further actions will be implemented as outlined in the practice Financial Policy.
Julie Hanson, LCSW Credit Card On File AgreementFile Agreement • October 10th, 2022
Outstanding Bills: It is not my policy to carry balances with my clients. CoPays are due at the time of service. Unless there is a Financial Hardship Form approved and on file, I will charge co-pays each session and/or charge deductible/co-insurance after insurance has processed the claim or at month end.
Signature On File AgreementFile Agreement • September 2nd, 2021
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Credit Card On File AgreementFile Agreement • August 10th, 2020
We have implemented a policy which enables you to maintain your credit card information securely on file with Richmond Creative Counseling (RCC). In providing us with your credit card information, you are giving RCC permission to automatically charge your credit card on file for your (or any other patient(s) you have listed on this form) co-pays/co-insurance, outstanding balances, services, and/or products.
Credit Card On File AgreementFile Agreement • April 26th, 2016
We have implemented a policy which enables you to maintain your credit card information securely on file with Bright Hearts Counseling (BHC). In providing us with your credit card information, you are giving BHC permission to automatically charge your credit card on file for your (or any other patient(s) you have listed on this form) co-pays/co-insurance, outstanding balances,
PAUL JOHNSONFile Agreement • May 8th, 2007
This is a legally binding contract between Chevy Chase Foot & Ankle LLC and you. The words, I, me, my, you and your all refer to the patient.File Agreement • October 8th, 2022
best to check your insurance benefits and eligibility prior to your appointment. Please understand that we are limited to the
CREDIT/DEBIT CARD ON FILE AGREEMENTFile Agreement • October 16th, 2020
AOK has implemented a policy requiring all AOK clients to keep a Credit or Debit Card on file for payment purposes. Our system enables us to maintain your Credit/Debit Card information securely on file and which can only be accessed under the terms you specify below.
FORUM FAMILY MEDICINE, PC CREDIT CARD ON FILE AGREEMENTFile Agreement • July 14th, 2020
Forum Family Medicine is now offering a secure and convenient method of payment for the portion of services your insurance does not cover. Your card number is kept confidential and stored on a secured credit card payment system.
