Common Contracts

1 similar Payment Policy contracts

PAYMENT POLICY
Payment Policy • September 29th, 2012

Thank you for choosing me for your speech-language pathology needs. This is an agreement between you and me, Nancy Sims M.A. CCC, Certified Speech-Language Pathologist, for payment of services provided. By signing this agreement, you are agreeing to pay for all services provided to you or your family member.