Common Contracts

2 similar Payment Agreement contracts

Catalyst Medical Group Payment Agreement, Disclosure Statement and Practice Policies
Payment Agreement • April 4th, 2024

This agreement and disclosure statement covers your account with us. In this agreement the words “you” and “your” mean the patient, or the patient’s spouse, or the parent or legal guardian of a minor patient or any other person financially responsible by law for the patient’s medical care. The letters “CMG” mean Catalyst Medical Group, PLLC and its providers and staff.

Catalyst Medical Group Payment Agreement, Disclosure Statement and Practice Policies
Payment Agreement • May 23rd, 2018

This agreement and disclosure statement covers your account with us. In this agreement the words “you” and “your” mean the patient, or the patient’s spouse, or the parent or legal guardian of a minor patient, or any other person financially responsible by law for the patient’s medical care. The letters “CMG” mean Catalyst Medical Group, PLLC and its providers and staff.