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Thirty Clinic, PLC Good Faith Estimate for Health Care Items and Services Patient Name: Date of Birth: Address:Apt:City:State:Phone:Email:Contact Preference:MailEmailZip:Phonetic following is a detailed
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Services and technology refer to the various tools, software, and solutions that are used to provide services to customers.
Any company or individual that utilizes services and technology in their business operations may be required to file information related to them.
You can fill out information related to services and technology by providing detailed descriptions, costs, and usage data of the tools and solutions being used.
The purpose of reporting on services and technology is to provide transparency and accountability in how businesses utilize technology and services to deliver products and services to customers.
Information such as descriptions, costs, vendors, and usage data of the services and technology being used must be reported.
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