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Effective treatment of my condition to Apex Physical Therapy and Wellness Center for the provision of care and for obtaining insurance reimbursement. Does not apply to Worker s Compensation or Medicare Patients I understand that I am legally responsible for payment to Apex Physical Therapy and Wellness Center for all services rendered. If my insurance is being billed I will be responsible for any remaining balance coinsurance and all co-payments/deductible amounts. I also acknowledge that...

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