Create a Patient Receipt Form

Using the Form links below, Patient Receipt and Refund Receipt Forms can be created and uploaded into the PM System.

 Map and Create a Patient Receipt Form 

• Use the System's Default Patient Receipt to create a new Receipt.

• Edit the Receipt Form as needed.

• Use the Print List of Fields to map the Refund Receipt Form.

• Save as a PDF after mapping the document.

• Upload into the PM System.

• Libraries > Forms > Add

• Form ID: RECEIPT
• Form Name: RECEIPT
• Template File Name: receipt.pdf
• Upload Choose file: receipt.pdf

• Select Save [F2].
  

Map and Upload a Refund Receipt Form

NOTE: A Patient Refund Receipt is not the same as a Patient Receipt Form.

These must be set up separately and are handled differently.

• Use the System's Default Patient Receipt to create a new Receipt.

• Edit the Refund Receipt Form as needed.

• Map the Receipt from the Print List of Fields using the Receipt Field IDs

• Save as a PDF after mapping the document.

• Upload into the PM System.

• Libraries > Forms > Add

• Form ID: REFUND
• Form Name: REFUND
• Template File Name: refund.pdf
• Upload Choose file: refund.pdf

• Select Save [F2].

 

Patient Receipt Form 

Patient Refund Receipt Form 

Learn More

List of Mappable Fields

Form Field Mapping

Upload a Form

Print Forms

Link Form to Appointment Types/Resources

Print Superbills and Forms from the Calendar

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