SAMPLE FINANCIAL POLICY SHEET
Any balance due or non covered services is your responsibility and is due upon receipt of a statement from our office. MINOR PATIENTS. For all services rendered to minor patients, the adult accompanying the patient is responsible for payment. I have read and understand the financial policy of the practice and I agree to be bound by its terms. ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- sample memorandum of understanding ms word
- sample monthly financial report connecticut
- sample financial policy sheet
- model cost policy statement msword
- sample hospital risk assessment recommendations
- sample performance improvement plan template
- internal audit plan template
- operations manual template hud
- collaborative practice agreement for nurse practitioner
- tool 11 community resource guide agency for healthcare
Related searches
- sample financial policy for nonprofits
- sample collections policy for business
- sample collection policy and procedures
- sample quality policy and objectives
- sample treasury policy and procedures
- sample office policy manual
- sample inventory policy procedures
- sample grievance policy printable
- sample telehealth policy and procedure
- sample grievance policy for clients
- sample procurement policy and procedures
- sample credit policy manual