Download, Record, Scan, Fax.

Anesthesia Charge Capture Form

For free to use. But why duplicate all this data entry? Document it once in Graphium’s EMR, and let us take care of the rest so you can focus on keeping patients safe.

Download our form today and start using it immediately for each case you perform. Better yet, let us give you a tour of our software using this exact form, keeping what you love about your paper record but getting rid of its weaknesses.

Charge Capture Form

Our clients want to streamline their current paper form processes. Feel free to use our universal Charge Capture form. Feel confident that you are recording what you need for MACRA Compliance and Quality, Operational Excellence, and now Charge Capture. Once your data is in our data warehouse, we can send it electronically to the RCM vendor of your choice. We make it really easy.

anesthesia billing form

Download Graphium’s Charge Capture Form

Fill out the form below, and we will send you the Charge Capture form, which you can print and start using right away.