releasesmpl.JPG

Release of Claims

Patient Release of All Claims: Release form for settlement of dispute between patient and provider, stating that "payment constitutes a final and full settlement of any claim I might have against the dentist in this particular case,..."
$15.00
Patient Release of All Claims: Release form for settlement of dispute between patient and provider, stating that "payment constitutes a final and full settlement of any claim I might have against the dentist in this particular case,..."