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Individual Forms
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$25 Initial Office History & Physical
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$30 Long and Short Progress note: one and two visits per
side
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$20 Daily hospital visit card 5 X
6
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Packages (ALL progress notes include coding prompts)
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$80 Office:
Patient Registration & ROS, H&P, Problem/Med
list, Long and short Progress notes, HIPAA
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$50 Hospital:
Comprehensive H&P, visit card and
progress note **
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$60 Nursing Home:
Geriatric Assessment, NH Admit
H&P, and NH progress note
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$30 Miscellaneous:
Injury Report, Asthma instructions
and screening reminder, Consult Request, Sx clearance, Medical Record
Release, Patient wallet medical information, Lifestyle changes
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Personalized Forms
Your name(s) under
signature lines as well as the
information you list below on forms where space is available.
$25 charge
$8 Shiping & Handling US Priority Mail: for paper or on disc pdf
Please make checks payable to: Theodore Christou
we also accept credit card payment by phone
* PER SOLO PHYSICIAN OR
UP TO 5 PERSON MEDICAL GROUP
** May require hospital form committee
approval.
All form changes billed hourly
at $80/hr
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