Test

Client Name*

Client Email*

Appointment Type*

Appointment Date*

How much did the Client pay?*

The actual amount the client paid for the treatment, including tip. If client's insurance covered 100% then enter 0 (zero).

Taxable*

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Treatment Price*

Excluding Tax

Payment Type*

Did the Client tip?*

Yes

Tip Amount

By selecting "Insurance" you're saying that the client's insurance company is paying 100% of the cost of treatment.

Is insurance paying for part of this?*

Yes

Eligible Amount*

Including Tax (if applicable)
How much of the price is the insurance company covering?

Insurance Pays

Client Pays*

Do not include tip here.

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Check if Client Pays Matches Client Paid

Whoops! It looks like what the client paid doesn't match what the client should have paid. Please check "Client Paid" and "Client Pays"

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