If you are a patient and the Dynasplint reps comes to your home to give you a splint DO NOT SIGN ANY FORMS. I'm a lawyer and needed a splint that of course my insurance wouldn't cover and the rep wanted me to sign this form. Legally it binds you financially responsible for all costs assocaited with the Dynasplint. A good company would write off what was not collected, medical companies do it all of the time. Don't be scammed into signing this form. I have posted the verbiage so you don't get taken for a ride. Here'... read full review »