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F202-I - Financial Arrangements, with imprint

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Your Price: $82.00

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Quantity Discounts - Order a quantity in the range below to receive the discount

QuantityAmount
2 to 2$65.60
3 to 3$57.50
4 to 4$53.00
Document financial agreements of 4 payments or fewer and no finance charge with this concise, 2-ply, carbonless form. Patient and witness signature reinforce commitment. (For more than 4 payments or for any arrangement with a finance charge, use the Truth in Lending Statement.)

Each package contains 250 sheets.

There is a $125.00 fee for new imprint set-ups, existing imprint revisions and type resets.

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F202 - Financial Arrangements, plain
Your Price: $42.00
F202 - Financial Arrangements, plain
For your benefit and your patients', record financial arrangements in writing with this simple form.
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