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Encounter Form

 

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This is a sample encounter form template in .xls format for Excel. You can change codes and descriptions as desired. The logo in the bottom right corner should be changed from mine to that of your practice. This form was designed for billing software that prints the patient's information in the bottom left corner. You can change that location if needed to adapt to your software.

Download the Encounter - Encounter Form


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Copyright 2007 SmartOB
SmartOB is a registered trademark and SmartOB Prenatal Forms are Copyright Charles S. Bloom, MD
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Last modified: 04/23/09