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$120*   Complete Practice Package
All the forms you need for a medical practice

Office Package
Nursing Home Package
Hospital Visit Cards
 Miscellaneous Forms Package

Individual Forms

   $25 Initial Office History & Physical

   $30 Long and Short Progress note: one and two visits per side

   $20 Daily hospital visit card  5 X 6

Packages (ALL progress notes include coding prompts)

$80 Office: Patient Registration & ROS, H&P, Problem/Med list, Long and short Progress notes, HIPAA

$50 Hospital: Comprehensive H&P, visit card and progress note **

$60 Nursing Home: Geriatric Assessment, NH Admit H&P, and NH progress note

$30 Miscellaneous: Injury Report, Asthma instructions and screening reminder, Consult Request, Sx clearance, Medical Record Release, Patient wallet medical information, Lifestyle changes

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

 
 

Submit Order form or Print and fax to: 708 563 0916
Call: 708 563 0330 for additional information

Forms delivered free electronically or
add $8 for disc as pdf files or CAMERA READY on acid free paper