oakwoodclinical.com
Oakwood Clinical Associates

Name

Address

City, State, Zio

Daytime Phone Number

Account number (if available)

Email Address

Best way to contact

Account Balance (if known)

First Payment Amount

Payment arrangement amount


Weekly


Bi-weekly


Monthly

Additional Information

Once submitted, your information will be sent to our billing department.

 

If your payment arrangment is accepted, you will receive an email and/or phone call to confirm your arrangments.

 

Some payment arrangements will require automatic billing of your payment terms. If you have any questions regarding this, you email billing@oakwoodclinical.com

 

 

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