Payment Options Acceptance Form Mobile App

Use the form to let patients know how they can pay for your services and have them sign off electronically to confirm their agreement with the listed terms.

The form can be customized to include different types of payments, including credit cards, debit cards, money orders, checks, fixed fee payment plans or direct draws from an account. Once completed, the signed form can be saved electronically for your records.

Industry: Health Care & Social Services Dentists

  • Apple
    iPhone, iPad
  • Android
  • Window

Why Customers Love GoCanvas

Reduces paperwork
Tracks jobs & expenses
Shows real-time data
Affordable plans
How It Works
I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.

Dave Kramer

PennLine Service

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