GI Consultation Retainer

This retainer is advanced and partial payment for the service state above. It is to be paid prior to the rendering of the above service. Appointments are given only after such retainer payment is received.
 
Collected retainer amount is applied to the charges incurred. Additional charges exceeding the retainer may be incurred depending on the insurance type, copay and deductible. Balance is returned promptly if opposite is true.