Submit Other Packing Slips

Submit
Other Packing Slips

to Billing and Accounting Dept.

Please scan your file in as a "Normal DPI," file type PDF (no more than 200DPI.)
Each file you submit here should be no more than 75 pages per individual file (with no blank pages scanned in).

* Indicates required field

Your Name *

First

Last

Today's Date *

Your Provider/Supervisor *

Clinic/Office Location (or Department allocation) *

Vendor Name *

Amount *

Is there any other information Billing and Accounting should know? Please write that information on the packing slip before you upload it below.

Upload Packing Slip *

Max file size: 1000MB

Upload Packing Slip *

Max file size: 1000MB

Upload Packing Slip *

Max file size: 1000MB

Submit

SubmitOther Packing Slips​to Billing and Accounting Dept.

Submit
Other Packing Slips

to Billing and Accounting Dept.