GENERAL CONDITIONS
I, the undersigned, understand I am personally responsible for payment if my medical aid opts for whatsoever reason not to pay the account. In the event of divorce, the parent accompanying the minor is responsible for settlement of the account. In the event of any legal action being instituted against me for recovery of any amount whatsoever, I shall be liable for all legal costs, including a 20% admin fee on each instalment paid. If the case is defended, I will be liable for legal costs incurred on an attorney/client scale. Once my account has been handed over, no further correspondence may be entered into with the practice, but only with the debt collection company chosen by the practice. The National Credit Act, no 34 of 2005, is not applicable to this claim. I hereby choose the address stated above as my domicilium citandi et executandi for all purposes under this agreement.
By signing this document, I proclaim I have read, understood and agreed to the conditions stated above. I confirm that the information provided is true and correct.
