Your Commitment: I, the undersigned, agree to be responsible for payment of all services rendered on my behalf or on behalf of my dependents. I understand that payment is due at the time of treatment, unless other arrangements have been finalised. A 15% fee may be added to outstanding amounts. If required for debt collection, I understand that any costs incurred while debt collecting will be on-charged to me and that a check of my credit history may be made, and/or my details may be passed to a third party. I understand that by making appointments with Bays Dental, I am agreeing to attend the appointments or to give a minimum of 24 hours’ notice of cancellation of appointments. If I fail to attend an appointment, a ‘no show’ fee of $50 per half hour of the appointment may be charged.