aesthetic dentistry SPECIALTIES

MY HEALTH CARE

Find healthcare providers by location. Then enter a specialty and/or name.
If you do not know the specialty, you may enter a concern or condition in the specialty box.

aesthetic dentistry View Doctors

aesthetic dentistry

Non-Associate

Kriss Ghafourpour

Address: 724 Bounty Dr Apt 2407, 94404-2655, San Mateo, San Mateo County, CA
Speciality: Implant General Dentistry Surgery,Implantgeneral Dentistryperiodontics,Impl
Phone: 5109620846
Website:

Advertise With Us

‹ ›

This Petition Slip is for you to present to the named Healthcare Provider as a written request for a price break on the office visit/service appointment which you are responsible to schedule. If a price break has not been determined prior to your appointment, feel free to remind the Healthcare Provider/staff that you are paying out-of-pocket that day. At this time it is important for you to ask the Healthcare Provider which form of payment they accept; Cash, Check or Charge.

PAYMENT DUE

When checking in at your appointment, payment will be required prior to receiving service.

HEALTHCARE PROVIDER

Name:
Location: , , , ,
Phone:

SERVICE PRICE PETITION

Office visit/service price to be determined between Patient and Healthcare Provider

PROVIDER SIGN-UP

Please ask your Healthcare Provider to visit MEDPRICE.COM to review the enrollment process. Our basic program allows Healthcare Providers to enroll as an Associate starting as low as $9.95 per month. It is designed to eliminate the 'sometimes awkward' face to face price negotiations with patients and to simplify the out-of-pocket payment method.

Print this out and take it with you to your appointment.