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	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 the Add to Reading List Document Date: 2015-01-27 08:20:29 Open Document File Size: 46,39 KB Share Result on Facebook

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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 List