All services provided to you, your dependents, or others for whom you are responsible, you will be responsible for payment for said services. Unless insurance is available or payment is otherwise prearranged, payment is due in full at the time of treatment. If treatment is terminated or suspended prior to your treatment being completed, any fees for services already provided shall become due and payable immediately. If the account is not paid as agreed upon and is turned over to collections, you agree that an additional fee will be added to your account balance to cover the costs of collection.
Returned checks shall incur a $25 return check charge and the patient will no longer be able to pay with a personal check.