Professional Charges Forms

Forms & Information
HTML Format in this column All Forms will open in new window.	Adobe PDF Format in this column Better quality requires Acrobat Reader

For Submitting Charges
Patient Payment Consent Form Client Payment Consent Form Receipt for Services Signed Receipt for Services optional Receipt for Refund	Patient Payment Consent Form Client Payment Consent Form Receipt for Services

For Membership	Adobe PDF Format in this column
Authorization and Agreement Form Member Agreement User's Guide	Authorization and Agreement Form Member Agreement User's Guide

For Associations	Adobe PDF Format in this column
Authorization and Agreement Form Member Agreement User's Guide	Authorization and Agreement Form Member Agreement User's Guide

Charges by Associations
Card Payment Authorization Requirements Receipt Requirements Refund Receipt Format	Card Payment Authorization Requirements

Forms & Information