The Lindner Center of HOPE (LCOH) appreciates the confidence you have shown in choosing us to provide health care services to you or a patient for whom you have responsibility. Our patient and family-centered treatment philosophy requires that we openly communicate our policies and expectations about payment for our services before treatment is initiated. Please take a moment to familiarize yourself with these policies.
In the event that my insurance will not cover the services provided or if I choose not to use insurance, I acknowledge that I am financially responsible for all charges associated with health care services provided by LCOH to me (or the patient named above). I understand that payment for services is due at the time services are rendered unless special arrangements are made in advance. Professional fees are billed separately.