There is a $35 charge for a returned check payable by cash or money order. This will be applied to your account in addition to the insufficient funds amount. You may be placed on a cash only basis following any returned check.
These policies help the office provide quality care to our valued patients.
If you have any questions or need clarification of any of the above policies, please feel free to contact us.
I agree to abide by the policies of the office and understand that if I do not, I may be asked to seek care elsewhere.
Acknowledgement Signature Required on Demographic Form.
East Lincoln Family Health Professionals, PC. RESERVES THE RIGHT TO CHANGE AND/OR MODIFY THE INFORMATION ON THIS SITE AT ANY TIME.