Daily COLLECTIONS FORM-Sample
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Client Name |
Amt. Due |
Amt. Paid |
Method of Payment: Cash/Check/Card |
Comments |
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Totals: |
Cash/Check/Card Totals: |
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- When collecting payments from clients.
- Provide a carbon/carbonless receipt.
- Enter all payments onto this ledger.
- Indicate both Amount Due & Amount Paid.
- Enter Method of payment:
- Indicate Cash
- If Check include the check # (stamp all Checks promptly with a “FOR DEPOSIT ONLY to CLINIC ACCOUNT)
- If Charge indicate Card Type (Visa/MC/etc.)
- Total all payments & verify against receipts
- Report Cash/Check/Credit Card Totals & cross check for accuracy with receipts.
- Record any comments about payment including lack of payment, pre-payment, concerns, etc
- Attach client receipts for all payments.
- Turn in daily to Billing Office/Owner for deposit.
