Dental Office Application With Sliding Scale In Collin
Category:
State:
Multi-State
County:
Collin
Control #:
US-00413-1
Format:
Word;
Rich Text
Instant download
Description
This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
Free preview
Form popularity
More info
The sliding fee scale program is available to uninsured patients who are unable to pay for medically necessary services at certain Northwell Health clinics. Procedures for patients requiring dental implants are provided.You may submit an application for the Sliding Discount Scale Fee to apply to the patient responsibility portion of the charges. All ages, based on sliding scale, preventative and restorative care. Grace Center Texas • . A patient will not be denied service(s) due to their inability to pay. Sliding Fee Scale Application. A sliding scale means that your cost is based on your income. You will need to fill out an application. The Sliding-Fee Discount Program is based on an individual's income and family size.