Fee Discount Agreement Forms
| Form Name | Fee Discount Agreement |
| Form # | 440-3659 |
| Form Revision | 12/08 |
| Category | Forms » Financial/Compensation |
| Downloads | |
| Form State | Oregon |
| Language | English |
| State Description | Form insurers, self-insured employers, medical service provider, or clinics must use when entering into a Fee Discount Agreement. |
| Claimwire Description | n/a |