From:Insight Family Practice

8686 S 1300 E, Suite L102-104
Sandy, UT 84094
US
Phone: (801) 997-0368
insightfamilypractice@gmail.com

To:Valentin Bullard

539 W Oakwood
Farmington, UT 84025
US
Phone: (385) 568-4100
Invoice # 5706
Issued on September 28, 2025
Due on October 27, 2025
Balance Due $45.00

Task 1.0

Owed for 1/16/25 appointment (copay)

Rate

$15

Qty

1

Amount

$15

Task 2.0

Owed for 2/27/25 appointment (copay)

Rate

$30

Qty

1

Amount

$30

Total Owed

Info & Notes

Thank you; we really appreciate your business.

Terms & Conditions

We do expect payment within 21 days, so please process this invoice within that time. There will be a 1.5% interest charge per month on late invoices.

Balance of $45.00 is Overdue Make a Payment

Make a Payment

Please enter your payment information to pay this invoice. A receipt for your records will be sent to you. Thank you very much!

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Invoice History

Status Update 322 days ago

Status changed: Draft to Pending.

Updated 322 days ago

Invoice updated by Insight Family Practice.

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Updated 9 days ago

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