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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Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Financial Policy & Agreement Form
Agree & Sign