| |
REPORTER FORMS |
| Instructions for Using the Billing Information Form |
Option One: FAX
- Open the form on our website by clicking on the link below.
- Print a copy of the form.
- You may want to save a copy of the form to your computer for future use.
- Fill out the form completely.
- Fax the completed form back to us at 954-467-8214.
|
Billing Information Form (54KB) |
NOTE: Fax Form is in Adobe Acrobat Format. Please download a copy of
Acrobat Reader if you do not
already have it.
|
|
| |
Option Two: Online form submission
- Click here to link to our online billing information form.
|
|
Online Billing Information Form |
| |
| |
| |