Financial Policy & Agreement Form


Denali Medical Center is dedicated to professionalism and caring for our patients. We hope to be as up front and consistent as possible in explaining your obligations in our partnership to your health.

Please read, check each box and sign where indicated – this document describes your financial responsibilities. This is a legally binding contract between Denali Medical Center and the patient.

 

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Document name: Financial Policy & Agreement Form
lock iconUnique Document ID: 3579462e64398aef1940ef166523d9ad1e5305e0
Timestamp Audit
July 9, 2019 8:34 am MDTFinancial Policy & Agreement Form Uploaded by Denali Medical - accounts@denalimed.com IP 107.191.1.125
July 10, 2019 8:40 pm MDTCindy Meldrum - cmeldrum@denalimed.com added by Lisa Strauss - accounts@denalimed.com as a CC'd Recipient Ip: 107.191.1.119