The form is signed by a patient when the Doctor agrees to put them on a hardship agreement in the office with the option to bill their health insurance for their care in the office (if the Doctor is in network). Updated Oct 2024
The form is signed by a patient when the Doctor agrees to put them on a hardship agreement in the office with the option to bill their health insurance for their care in the office (if the Doctor is in network). Updated Oct 2024
