What Is Consent

Abbey Road Counseling Services, Inc. Gary W. Munn, LCSW | mooring: | | |415 North Main Street, Ste. 104 | delegacy (435) 586-9521 | |Cedar City, Utah 84720 |FAX (435) 586-4268 | | | | CONSENT AND CONDITIONS FOR TREATMENT work of reading: The law requires Gary Munn to make and keep shows of your medical exam intercession/counseling. Gary Munn safeguards tho se records. By receiving services provided by Gary Munn, you guard to the release of medical record information to amends companies or other tercet parties to suffice in paying your health care costs. monetary function: Patient and the undersigned, if other than the unhurried, each jointly and on an individual basis agree to pay for all the services rendered to patient by Gary Munn, including tho non limited, to whatever amounts non paid by whatsoever amends company or other third troupe payer. Patient and the undersigned if other than the patient, remains responsible for all co- hires, deductibles, co-insurance, and/or non-covered services regardless of amount paid by insurance or third party payer. It is understood and agreed that charges non paid in a timely matter whitethorn be placed for collection or with an attorney for purposes of collection. It is crusade understood and agreed by the patient and the undersigned that any amounts not paid wit hin 30 days of the statement for pay shall ! accrue interest at the rate of 1 ½% per month (18% per year) on the undischarged balance. In the event that any outstanding balance is placed for collection or with an attorney for collection, patient and the undersigned, if other...If you want to get a full essay, order it on our website: OrderCustomPaper.com

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