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Get JLFHC Weekly Invoice for Companion Services 2013

________________________ By signing below, the Client (or Client’s Representative) is aware of and agrees that the role of Just Like Family Home Care (JLFHC) in this agreement is to act as the billing and collection agent for the independent contractor (Companion) specified above. To support billing and reimbursement, as well as other documentation requirements, the Companion will specify below the services he/she provided to the client, and will submit such completed form to JLFHC weekly for .

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