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Date: 2015-01-27 08:20:29 | Main Street Medical FINANCIAL RESPONSIBILITY AGREEMENT Payment is required at the time of service. Payment may be made by cash, check or major credit card. Any deductible, co-insurance or co-payment is payable at theAdd to Reading ListSource URL: www.hiltonheadurgentcare.orgDownload Document from Source WebsiteFile Size: 46,39 KBShare Document on Facebook |