Divorce/Separation Policy

A divorce decree is a legal agreement binding only upon two parties who made the agreement. Therefore, Pack Pediatrics is not a party to that contract. Both parents remain responsible for the child’s bills and that responsibility will be determined by the person signing this financial policy. Payments will still be collected and due at time of service by the accompanying adult. Please notify our practice of divorce or separation, and update any contact or mailing information. If your divorce or separation agreement includes restricted access to patient records, specific financial responsibility or other specification, please send that information in writing including any court orders restricting access. Disagreements that interfere with our ability to provide proper care to your child may result in a discharge from the practice.