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financialpolicy2006 pdf

Size: 69 Kb Pages: 2 Date: 2013-01-14
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financialpolicy2006 pdf
financialpolicy2006 pdf

We do ask that you pay your portion at each visit. If you share our belief in quality dentistry—the best we can possibly do—then we’ll find a way to make it part of your life. Very truly yours, Dr. Simpson and the Team NOTICE TO INSURANCE CO. This instruction to you is an assignment of my rights under dental coverage to the extent of ALL bill accrued by me at this office.

Size: 69 Kb Pages: 2 Date: 2013-01-14

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