TRAINING Template Money Worksheet (make a copy)
 Share
The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

View only
 
 
ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
Download this form as an Excel
2
3
Patient Application
4
5
FirstInitialLastDate of Birth
6
7
AddressPostcode
8
9
10
11
12
Recommended TimelineDateTime
Recommendation
13
Patient LiasionSurgeon
14
15
Date of initial consultationInitial consultationincluded
16
Facility feeincluded
17
Date of surgerySurgeon feeincluded
18
Post-op medications and supplies
included
19
Date of first follow upFollow up appointmentsincluded
20
1 year of enhancement if required and medically approvedincluded
21
22
23
Total investment£ 3,000
24
25
Initial investment due today£ 500
26
27
Balance due 1 week prior to surgery£ 2,500
28
29
30
Financing Examples Only12/24
31
Principal Loan AmountTerm of Loan (Months)Monthly Principal PaymentMonthly Interest PaymentAnnual Interest Rate
Monthly Interest Rate
Total Payment
32
Interest Free Option 1£ 2,50012£ 208£ 00.0%0.0%£ 2,500
33
Principal Loan AmountTerm of Loan (Months)Monthly Principal PaymentMonthly Interest PaymentAnnual Interest Rate
Monthly Interest Rate
Total Payment
34
Interest Free Option 2£ 2,50024£ 104£ 00.0%0.0%£ 2,500
35
Principal Loan AmountTerm of Loan (Months)Monthly Principal PaymentMonthly Interest PaymentAnnual Interest Rate
Monthly Interest Rate
Total Payment
36
Interest Bearing Option 2
£ 2,50036£ 69£ 4119.9%1.7%£ 3,993
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Loading...
Main menu