CONFIDENTIAL FOR AUTHORIZED PERSONNEL ONLY (1) DIABETIC (1) FINAL NOTICE *THIS IS THE LAST STATEMENT THAT WILL BE SENT TO YOU. *REMIT PAYMENT IN FULL TODAY! *WE ACCEPT VISA & M (1) FINAL NOTICE IF WE DO NOT RECEIVE YOUR PAYMENT BY ___ WE WILL BE FORCED TO TURN YOUR ACCOUNT OVER FOR COLLECTION. (1) FINAL NOTICE IF WE DO NOT HEAR FROM YOU WITHIN 10 DAYS, THIS ACCOUNT WILL BE TURNED OVER TO OUR COLLECTION AGENCY. (1) FINAL NOTICE! (2) FOR YOUR CONVENIENCE, YOU MAY TRANSFER THIS BALANCE TO YOUR CREDIT CARD ACCOUNT. TO PAY WITH YOUR CREDIT CARD, PLEASE C (1) FRIENDLY REMINDER THIS ACCOUNT IS PAST DUE. YOUR PROMPT ATTENTION IS COURTEOUSLY REQUESTED. (1) HIPAA (1) IF YOU ARE UNABLE TO PAY IN FULL PLEASE SEND A PARTIAL PAYMENT (1) JUST A FRIENDLY REMINDER THAT YOUR ACCOUNT IS OVERDUE. WON'T YOU PLEASE MAIL YOUR REMITTANCE? (1) MEDICAL ALERT (1) PAST DUE PLEASE REMIT TODAY! (1) PAST DUE PLEASE CONTACT US AT ONCE REGARDING YOUR OVERDUE ACCOUNT (1) PAST DUE PROMPT PAYMENT OF THIS BALANCE DUE WILL PRESERVE YOUR GOOD CREDIT RATING. MAIL YOUR CHECK TODAY. (1) PAST DUE WE ACCEPT VISA AND MASTERCARD. CALL OUR OFFICE WITH YOUR CARD NUMBER. (1) PATIENT RECORD CONFIDENTIAL (1) PLEASE CONTACT OUR OFFICE REGARDING YOUR OVERDUE BALANCE. WE'D LIKE TO WORK WITH YOU TO DEVELOP A REASONABLE PAYMENT P (1) PRE-MEDICATE (1) REGULAR MONTHLY PAYMENTS ARE NECESSARY TO KEEP THIS ACCOUNT CURRENT (1) RUSH (1) SELF PAY (1) SIGN HERE - With Arrow (1) THANK YOU! (1) THIS BALANCE IS OVERDUE! PROMPT PAYMENT WILL AVOID COLLECTION PROCEDURES. (1) THIS BALANCE MAY BE TRANSFERRED TO YOUR VISA OR MASTERCARD JUST CALL US (1) YOUR ACCOUNT IS PAST DUE. WE WOULD APPRECIATE YOUR PAYMENT TODAY! (1) ***Will be DISCONTINUED once stock is depleted*** (3)

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