Find Jobs
Hire Freelancers

BRR New Client Info and Tx Consent

$10-30 USD

完了済み
投稿日: 9年以上前

$10-30 USD

完了時にお支払い
I need to have a form recreated with a couple of small changes to the text: 1. Delete the first paragraph on the second page 2. Change the second paragraph to read: I agree that I am financially responsible as indicated in the Financial Responsibility Form and agree to pay all fees and charges related to my treatment unless another party agrees in writing to be financially responsible in my stead. If a party other than myself agrees to be financially responsible for my treatment, my signature below constitutes my consent to release information for the following: a) the fact that I am in treatment with Bright Road Recovery; b) dates and types of service; c) billing and accounting information, including diagnosis for the purposes of providing superbills or other insurance-related purposes; d) billing, accounting and/or superbill information may be exchanged via e-mail with the financially responsible party (unless I indicate I do not wish to have information shared via email). 2a. The "I agree" radio button is a required field--which is to say that it has to be chosen as part of the form in order to continue/sign it/save it. 3. The boxes under the superbill paragraph should be an either/or option, not requiring both boxes to be checked
プロジェクト ID: 6696156

プロジェクトについて

4個の提案
リモートプロジェクト
アクティブ 9年前

お金を稼ぎたいですか?

Freelancerで入札する利点

予算と期間を設定してください
仕事で報酬を得る
提案をご説明ください
登録して仕事に入札するのは無料です
アワード者:
ユーザーアバター
Thanks again for the job Tamson. Appreciate it.
$20 USD 2日以内
5.0 (3 レビュー)
1.8
1.8
この仕事に4人のフリーランサーが、平均$19 USDで入札しています
ユーザーアバター
Hello there, It is my great honor to apply for this job vacancy. I am very hardworking and can work effectively as fast as I can. I have excellent skills in Graphics Design, Data Entry, Web Research and Microsoft Office and I have enough experience with different kinds of tasks as you can see in my "Work History", most of the time I gave my clients a great resultI can follow instructions very well and will deliver the project on time. It is a pleasure if ever you will message me for an interview. I can work as soon as possible.
$15 USD 0日以内
5.0 (3 レビュー)
3.7
3.7
ユーザーアバター
Sir, I am highly experienced graphic designer having 12 plus years of experience, I have read your project description fully and looked at the attached files and very clear with your requirement. I will help you in making changes according to the instruction. Ready to start immediately. Trust and try once it will never go waste. Thank You Printy
$30 USD 1日以内
5.0 (4 レビュー)
3.4
3.4
ユーザーアバター
A proposal has not yet been provided
$10 USD 1日以内
0.0 (0 レビュー)
0.0
0.0

クライアントについて

UNITED STATESのフラグ
Claremont, United States
5.0
7
お支払い方法確認済み
メンバー登録日:8月 28, 2014

クライアント確認

ありがとうございます!無料クレジットを受け取るリンクをメールしました。
メールを送信中に問題が発生しました。もう一度お試しください。
登録ユーザー 投稿された仕事の合計
Freelancer ® is a registered Trademark of Freelancer Technology Pty Limited (ACN 142 189 759)
Copyright © 2024 Freelancer Technology Pty Limited (ACN 142 189 759)
プレビューを読み込み中
位置情報へのアクセスが許可されました。
あなたのログインセッションの有効期限がきれ、ログアウトされました。もう一度ログインしてください。