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QUOTATION DETAILS
Practice Name:
*
Practice No:
Date:
Valid Until:
PRODUCT / SERVICES SELECTION
Billing Software (PMA):
-- Select --
Elixir Live Premium
Elixir Live Aux Lite
Elixir Live Bureau
Elixir Live Simplicity+
Elixir Live Intelligent Billing
HealthONE Solution GP
HealthONE Solution SP
HealthONE Solution Aux/Allied
HealthONE Bureau
Aux Elive
H1 Cloud Specialist
H1 Cloud GP
H1 Cloud Aux/Allied
Elixir Classic
ME+
ME+ Clinic
ME+ Lite
Switching Software:
-- Select --
SwitchON
Conversion Fee required?
Yes, include Conversion Fee
Training required?
Yes, include Training Fee
ADDITIONAL PRODUCTS / SERVICES
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PRICING SCHEDULE
DESCRIPTION
QTY
UNIT COST
ONCE-OFF
MONTHLY
×
Sub Total
VAT (15%)
Total Payment Due
+ Add Own Row
LIST OF BUREAU PRACTICES
Full Names
Practice No
HPCSA No
Discipline
Bundle Size
Out of Bundle Rate
×
+ Add Practice
PREPARED BY
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