Cash Price Request Form - CHRISTUS Trinity Mother Frances Health System

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Cash Price Request Form

Thank you for choosing CHRISTUS Trinity Mother Frances Health System for your healthcare needs. Your request for pricing information regarding Medical, Surgical or Physician services is just an estimate and could change if the service changes or if any additional services are added at a later time. The estimate you receive will not include any professional services for which CHRISTUS Trinity Mother Frances Health System does not bill for, such as but not limited to radiologists or pathologists.

Your request for pricing information regarding Medical, Surgical or Physician services is just an estimate and could change if the service changes or if any additional services are added at a later time. The estimate you receive will not include any professional services for which CHRISTUS Trinity Mother Frances Health System does not bill for, such as but not limited to radiologists or pathologists.

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