Are you an RD in private practice that does or does not accept insurance, but your client has asked for a receipt to submit to insurance? This one-page Super Bill will fit the “bill”! It includes all the elements needed for your client to successfully submit for reimbursement by their company or keep for their private records. Don’t recreate the wheel. Everything you need is on this form. Form can be customized to add your practice logo, web site and contact information.

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