Delivery System Cash Payments

 

DELIVERY CHARGE

CASH / CARD PAYMENT AT THE TILL RECORD FORM

 

ONLY USE THIS OPTION WHERE A CUSTOMER HAS DECLINED SETTING UP A DIRECT DEBIT.

A DIRECT DEBIT IS THE PREFERRED PAYMENT OPTION.

THIS FORM MUST BE COMPLETED FOR ALL CASH PAYMENTS TAKEN. 

Yearly Delivery Charge Paid

YOU WILL RECIEVE AN EMAIL NOTIFICATION IN 12 MONTHS TO REMIND YOU TO CONTACT THE PATIENT TO PAY AGAIN OR REMOVE THEM FROM THE SERVICE.