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I understand and agree that health and accident insurance policies are an arrangement between and insurance carrier and myself. Furthermore, I understand that KANADY CHIROPRACTIC CENTER INC. will prepare any necessary reports and forms to assist me in making collections from the insurance company, and those collections will be credited to my account on receipt. However, I clearly understand and agree that all services rendered me are charged directly to me and that I am personally responsible for payment. I also understand that if I suspend or terminate my care and treatment, any fees for professional services rendered me will be immediately due and payable.