F202 – Financial Arrangements, plain

F202 – Financial Arrangements, plain



Quantity Discounts - Order a quantity in the range below to receive the discount

Quantity Amount
2 to 2 $40.50
3 to 3 $39.50
4 to 4 $39.00


Document financial agreements of 4 payments or fewer and no finance charge with this concise, 2-ply, carbonless form. Patient and witness signature reinforce commitment. (For more than 4 payments or for any arrangement with a finance charge, use the Truth in Lending Statement.)

Each package contains 250 sheets.

Additional information

Weight 3 lbs