OFFICE FINANCIAL POLICYOffice Financial • September 11th, 2022
Thank you for choosing us to provide your dental care. We are committed to providing you with excellent care, and timely payment of fees allows us to devote more time and effort to caring for you and your smile. Our Financial Policy is based on an open and honest discussion of our fees. Please read, sign and return this agreement.
OFFICE FINANCIAL POLICYOffice Financial • February 24th, 2014
Thank you for choosing Next Level Dental, P.C. as your dental care provider. Our office is committed to successful care and treatment of our clients. Please be aware that payment is considered part of your dental treatment. We require that you read and sign this agreement prior to any dental treatment.
Office Financial Policy Agreement 01/15Office Financial • January 29th, 2022
We would like to thank you for choosing BalanceMD as your specialty medical provider. We are committed to providing you with quality health care and appreciate your commitment to adhere to this Office Financial Policy Agreement.
OFFICE FINANCIAL POLICY AND CONSENT FOR DISCLOSUREOffice Financial • February 2nd, 2010
Thank you for selecting Santa Monica Dermatology Medical Group for your medical care. We look forward to assisting you with your healthcare needs. In order to prevent any misunderstanding concerning your medical care, including the responsibility for payment, please read and sign this agreement prior to treatment.
