Billing Charge Slips (and HIPAA-Compliant Upload)

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• Download the OBB Charge Slip below.  Complete the form and save your changes (remember the saved name to help find it later when submitting it in the next step).

• Click HERE to securely submit your completed charge slips, along with other relevant billing materials, to O'Brien's Billing for processing.

To be used in-office if patient is unable to complete the Intake Questionnaire.  

Print and sign for your HIPAA compliance records.