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Patient Registration  Orthopedic Solutions, LLP  Form

Patient Registration Orthopedic Solutions, LLP Form

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Service fee I will be fully responsible for all attorney fees court costs and other legal expenses that incur as a result of said collection action. The undersigned agrees that should a suit be filed venue location of suit shall be held in Prince George s Howard Montgomery and Anne Arundel Counties and the District of Columbia. I certify that the information I have reported with regards to my insurance coverage is correct. To facilitate your ability to pay for services rendered we accept Cash...
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