Accounting Student Form

Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 1

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You just turned 70 years old. Happy birthday! But it’s also time for your annual wellness exam.

 Adult Wellness Care, 65 + years

Uh-oh… your doctor believes you may be deficient in Vitamin B12. He recommends you have an injection while
you’re here.

 Intramuscular Vitamin B12 injection

The physician also thinks it might be a good idea to check you for any signs of osteoporosis, as they are often
suggested for patients your age.

 Dexa-Scan

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 1 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 2

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You have decided to become a professional truck drive. Congratulations! But to qualify for your Commercial Driver
License (CDL), you must pass a Department of Transportation physical exam.

 DOT physical

Uh-oh… during your physical, the doctor notices your cough. You told him you’ve had it for about a month now. The
doctor orders a chest X-ray to make sure it’s nothing serious.

 Chest X-ray

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 2 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 3

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You are the parent of two beautiful children. You have one three-year-old boy named Cadon and one thirteen-year-
old girl named Carolynn. Congratulations! But it’s time for their annual well child exams.

 Well Child Exam, 1 – 4 years

 Well Child Exam, 12 – 17 years

It’s also time for some vaccinations. Cadon needs his measles, mumps, and rubella (MMR) vaccine. You’ve also
decided to give him the Varivax vaccine, which will protect him from the chickenpox.

 MMR vaccine

 Varivax vaccine

Carolynn needs her tetanus, diphtheria, and acellular pertussis (whooping cough) booster vaccine, called Adacel.
You’ve also decided to give her the Gardasil vaccine, which will protect her from the human papillomavirus (HPV),
a disease that can cause cervical cancer.

 Adacel vaccine

 Gardasil vaccine

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 3 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 4

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You recently quit smoking. Congratulations! That was an excellent decision. But you’re still experiencing some
shortness of breath and a lingering cough. You decide to visit your physician.

 Expanded, problem-focused office visit

While the doctor doesn’t think this is overly abnormal, she does suggest a chest X-ray and spirometry, just to make
sure there’s no permanent damage to the lungs.

 Chest X-ray

 Spriometry

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 4 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 5

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You are a senior-level advertising executive for a hugely successful firm. Congratulations – that’s impressive! But,
your stressful job has taken its toll on your heart. You were recently in the hospital for severe chest pain, and your
doctor wants to follow up with you.

 Detailed office visit, established patient

While you seem to be feeling better, your physician wants to make absolutely sure you are healthy! She orders an
ECG stress test, which is a test that measures the function of your heart while exercising.

 Stress ECG – Treadmill

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 5 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 6

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You are a world-renowned chef from New York City. Wow! You are known for your talent with steak and burgers.
But recently, you’ve been experiencing some digestive discomfort, and would like to see a physician about it. You
just moved to the other side of town, and have to find a new doctor.

 Detailed office visit, new patient

While documenting your personal and family medical history, your physician finds that you have a family history of
colon cancer. Because of this and your affinity for red meat, which is sometimes said to influence the development
of colon cancer, he suggests a colonoscopy.

 Colonoscopy

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 6 of 7
Copyright © 2016 Applied Educational Systems
Accounting Student Form
Explore: Accounting
Name: ___________________________________ Class: ______________ Date: ________
PROCEDURE SCENARIO 7

Below is your procedure scenario. The bulleted points are the procedures you will have to
pay for when you visit the physician. Your physician will tell you how much they cost.

The physician should enter the amount of each procedure in the blank next to the
procedure. Then, he or she will add up the costs and give you a total price. This form will act
as your bill. You must pay the physician the amount owed on your bill. If you do not have
enough, you’ll have to ask the physician for credit.

You are about to be married. Congratulations! You both have decided to travel through Brazil for your honeymoon.
But in some other countries, certain diseases are more common than here in the United States. So before you go,
you need some travel vaccinations.

 Typhoid immunization

 Yellow fever immunization

 Hepatitis B vaccine

While looking through your past shot records, you also realize that you may not be up-to-date on your measles,
mumps, and rubella vaccination. You decide to get one just in case. Better safe than sorry!

 MMR vaccine

Total Amount Owed:

Total Amount Paid:

Amount of Credit:

Money Left Over:

Page 7 of 7
Copyright © 2016 Applied Educational Systems