friends
faqs
contact
blog
home
prices/services
patients
providers
insurance reps
apprentice/externs
events/talks
Pride in our work, Commitment to our clients, and Integrity in our practices.
frequently asked questions
Questions? Favored Medical Billing has the answers.
patients
providers
Consultant Contract
Thank you for selecting Consulting Services from FMBS. Please review the FMBS Consulting & Retainer Agreement provided below. Upon careful review, please complete the Consultant Contract Form.
FMBS Consulting & Retainer Agreement
ALL FIELDS REQUIRED
Confirm:
I have read, fully understand, agree to the terms outlined in the FMBS Consulting & Retainer Agreement provided above. Completion of this form acts as my electronic signature.
Contract Term (in months):
Select Contract Term
2 Months
4 Months
6 Months
8 Months
10 Months
12 Months
Contract Effective Date:
Client's (Practice) Name:
Responsible Party:
Street Address:
City, State and Zip:
Phone Number:
Client's Email:
Are you a medical provider interested in medical billing and coding services?
Get started now!
General Inquiries
Please send us a brief message
and we will follow up with you shortly!
Stay Connected
▲