How to create medical form and collect payments

I need help billing.

Hi Ciampa,

Thanks for reaching out to Jotform Support. Can you let us know what type of the help you need in the billing side? Do you have paid Jotform account? Can you please share with us the username for the paid Jotform account so, we can check?

After we hear back from you, we’ll have a better idea of what’s going on and how to help.

Hello we need help on how to bill medical and get paid

Hi Ciampa,

I am not sure I understand your concern correctly. Do you want to create a form for medical form and request a payment? If yes, you can check our Free medical form templates that you can use here.

We have payment integrations available to legitimately collect payment from your customers. Collecting payments via Jotform is very easy, all you have to do is create a form and integrate it with one of the 40+ Payment Gateways that Jotform provides. Let me show you how to create a form and set up a Payment Integration:

1. On your My Forms page, click on Create Form, and then select Start From Scratch.
2. Now, select Classic Form, and once your form is created, click on the Add Form Element menu on the top-left side of the page.
3. Add the fields that you want to have on your form, and then go to the Payments tab.
4. Select a Payment Gateway, and then click on Connect in the menu on the right side of the screen.

If that’s not exactly what you’re looking for, can you explain a bit more so I can help you better? It would help us to understand what’s happening if you could take a screenshot and send it to us. We have a guide here explaining how to do that.

Once we have a better idea of what’s going on, we’ll be able to come up with a solution.

I am looking in for some help on guiding me on how to use the cms 1500 form.

Hi Ciampa,

You can create a Smart PDF form if you want to use the CMS 1500 form. You can create a fillable PDF form through the Jotform PDF Editor if you will be making the form from scratch. If you have a PDF Form, then you convert it into a fillable form or the Smart PDF Forms.

The Jotform Smart PDF Forms accepts documents up to 25 pages long. If your PDF exceeds the number of pages, you will get an error and won’t be able to import the file. Also, the Smart PDF Builder will only import your PDF fields to create the online form version, not its design. You will need to download the PDF Forms first, then create the Smart PDF Form.

We've made a small guide explaining the main aspects of Smart PDF Forms that you might find helpful.

1. Creating a Smart PDF form:

• Go to your My Forms page, and click on the Create Form button.
• After clicking on it, select Import Form and click on Import PDF Form.
• Then, it will redirect you to the Smart PDF Forms page.
• Now, click on Upload PDF and upload your document to Jotform.

2. Matching form fields with the original PDF document:

As a default feature, whenever a PDF document is uploaded to the system, it automatically connects fields with the original PDF document. If there is any problem with the connections, you can manually connect your form fields with your PDF document. It’s really easy. Let me show you how:

• In Smart PDF Forms, select the field that has no connection with the original PDF document.
• After selecting it, click on the Add to PDF button.
• Then, move your cursor over the PDF side of the screen, and then position and resize it the way you want it.

3. Adding Form Elements, Payments, or Widgets manually:

• In Smart PDF Forms, click on the Add Form Element menu on the right side of the screen.
• In the menu that appears on the left side of the screen, you can add anything you like.

4. Designing Smart PDF Forms:

• In Smart PDF Forms, click on the Paint Roller icon on the right side of the screen.
• In the menu that appears, you can design your form anyway you prefer.
• Also, you can inject CSS codes to the Inject Custom CSS Codes section under the Style tab.
• After you make your changes, click on Save.

5. Disabling the right panel:

• In Smart PDF Forms, in the blue navigation bar at the top of the page, click on Settings.
• In the menu that come sup, disable the Original PDF connection to your Online Form option.

6. Publishing the Smart PDF form:

• In Smart PDF Forms, in the blue navigation bar at the top of the page, click on Publish.
• Here, you can publish your form using the link, email, or QR code.

7. Disabling the PDF thumbnail on the welcome page:

• In Smart PDF Forms, in the blue navigation bar at the top of the page, click on Settings.
• In the menu that comes up, uncheck the Show PDF thumbnail on the welcome page option. 

You can also check out this page to get more information about the Smart PDF Forms feature.

Give it a try and reach out again if you have any other questions.