Massage Invoice for Treatment of Services Mobile App

Included Fields

Customize to add, remove, or edit any of the fields below.

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  Invoice number

• 

  Invoice date

• 

  Provider name

• 

  Practitioner number

• 

  Payee number

• 

  Mailing address for payment

• 

  Telephone number (include area code)

• 

  Email

• 

  GST registration number

• 

  (worker or other person who received service)

• 

  Service recipient name

• 

  Service recipient date of birth

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  Service recipient personal health number

• 

  Gender

• 

  Date of injury

• 

  Claim number

• 

  Diagnostic code (ICD9)*

• 

  Side of body code

• 

  Body part code

• 

  Nature of injury

• 

  Select ONE only:

• 

  Service location code

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  Date of service

• 

  Fee code

• 

  Service description

• 

  Number of service units

• 

  Cost (cost per unit)

• 

  Line item amount

• ...and More!