Allergy Associates of Western Michigan, P.C
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It is the policy of this office that the adult presenting the child for treatment is responsible for payment of the patient’s portion at the time of service.
I authorize the Physicians and staff of Allergy Associates of Western Michigan to access my outside prescribing history and transmit prescription information for me to the pharmacy I have selected.I understand that:
FINANCIAL POLICYI authorize payment of benefits, where applicable, directly to these physicians otherwise payable to me for these services.I understand that if Allergy Associates of Western Michigan participates or is contacted by my insurance company they will:
I understand that as a patient of Allergy Associates of Western Michigan:
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