I understand and accept the following terms and conditions:
• I agree that facility personnel are authorized to order purchases and charges on behalf of the above named resident.
• I agree to pay all charges incurred by the above named resident that are not paid by third party payors and additional charges for specially packaged medications.
• I will pay the entire amount due within the terms of the statement in accordance with each statement. I also understand that late charges will be added to balances owed for delinquency of 30 days or more.
• I agree that in order for the resident's account to remain active, payment/or billed charges must be made promptly pursuant to these terms.
• I agree to pay all charges of collection, including court costs and attorney's fees, for all delinquent balances.
• I understand that the medications furnished to the above named resident are not packaged in child proof containers.