· all insurance benefits, if any, otherwise payable to me for services rendered I understand that...
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Transcript of · all insurance benefits, if any, otherwise payable to me for services rendered I understand that...
![Page 1: · all insurance benefits, if any, otherwise payable to me for services rendered I understand that I am financially responsible for all charges whether or not paid by insurance.](https://reader035.fdocuments.net/reader035/viewer/2022071011/5fc9b8e2fc82770dd50acb70/html5/thumbnails/1.jpg)
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