Insurance/Credit card authorization form

[Hersheydmd]

Does anyone have a credit card authorization form? I already have a recurring payment authorization form, but I need a form for the balance after insurance pays. Thanks in advance.

[rhaber123]

check this form and make your own:
http://imaging.ubmmedica.com/all/editor ... POLICY.pdf

[Hersheydmd]

Here is my insurance/credit card authorization form:

2017-07-18.png (122.02 KiB) Viewed 3543 times

Insur_auth-and-credit_card.xml

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