HTML Preview Final Payment Letter page number 1.
SAMPLE REMINDER LETTER
Date:
John Doe
Address
City, State, Zip Code
Dear Mr. Doe,
This letter is to remind you of your outstanding balance in the amount of $
____________. Please remit this balance within ten (10) days or contact our
office at ________________ to advise us when we can expect to receive your
payment or if you would like to make other financial arrangements with us.
As a courtesy to our patients, we do accept MASTER CARD AND VISA. If you
choose to pay your balance with this option, simply complete the form at the
bottom, sign and return this letter to our office.
If you have already mailed your payment, please accept our thanks and
apologies for any inconvenience this may have caused.
Sincerely,
Patient Account Coordinator
MASTER CARD VISA
Card # Expiration Date
Cardholder’s Signature Date
Cardholder’s Name Amount $