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F202-I - Financial Arrangements, with imprint
F202-I - Financial Arrangements, with imprint
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Your Price:
$76.00
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Quantity Discounts - Order a quantity in the range below to receive the discount
Quantity
Amount
2 to 2
$60.80
3 to 3
$53.96
4 or more
$50.16
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 $70.00 fee for new imprint set-ups, existing imprint revisions and type resets.
Related Products
F202 - Financial Arrangements, plain
Your Price:
$38.00
For your benefit and your patients', record financial arrangements in writing with this simple form.
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