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Notice of Past Due 30 Days

Won-Woo Jonathan Park

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Notice of Past Due 30 Days

Signed Date

Date

OoLi Orthodontics Location

OoLi Orthodontist Name

Patient Name

Address

Patient Email

Patient Phone

Financial Promissory Note Singer




Financial Obligation Due Date

Financial Obligation Past Due Amount

Financial Obligation Total Balace

 

This letter is to inform you of your past due balance. Please see your financial obligation to date, which is noted above.

From our previous experience, we find that if the payment is not made on time, they become further delinquent. Once delinquent, it becomes difficult to catch up and remain current on your account.

We are certain that a reminder is all that is necessary to prevent the payment from becoming further past due.

If there is a problem causing a delay in your payment or if you feel that our record is in error, please contact us immediately to resolve this matter.

Thank you for your prompt attention to this matter.


Sincerely,

W.W. Jonathan Park, DMD, MS

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wpesig-user-profile

Notice of Past Due 30 Days

Won-Woo Jonathan Park

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Thank you for signing your document. If you need to fill out any additional documents, you can do so here: https://ooliortho.com/patient-forms/ If you've already filled out and signed what you need, there's nothing else you need to do except show up for your appointment! Congratulations! We look forward to meeting you!

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