---
title: Medical Charge Capture Software Trial Request Form Template | Paperform
description: Professional trial request form for hospitals evaluating medical charge capture software. Captures provider count, billing complexity, compliance requirements, and revenue cycle director approval.
url: "https://paperform.co/templates/medical-charge-capture-software-trial-request"
type: static
generatedAt: "2026-03-28T00:44:28.008Z"
---

[← Back to free form templates](/templates/)    ![Medical Charge Capture Software Trial Request](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-charge-capture-software-trial-request.png)
    [Preview](https://_preview.paperform.co/ai-template/medical-charge-capture-software-trial-request) [Use this template for free](/create?ai-template=medical-charge-capture-software-trial-request)    [Order & Booking Forms](/templates/category/orders/)[Healthcare & Medical Forms](/templates/category/healthcare/)[SaaS & Startup Forms](/templates/category/saas-startups/) [Software & SaaS](/templates/industry/software-saas/)[Healthcare](/templates/industry/healthcare/) [Manager](/templates/role/manager/)[Healthcare Administrator](/templates/role/healthcare-admin/)[IT Professional](/templates/role/it-professional/)[CFO](/templates/role/cfo/)     About this free form template
### Medical Charge Capture Software Trial Request Form

Managing revenue cycle operations in a hospital environment requires sophisticated tools that can handle complex billing workflows, ensure compliance, and maximize revenue capture. This **Medical Charge Capture Software Trial Request Form** is designed specifically for healthcare organizations evaluating charge capture solutions.

#### Built for Healthcare Revenue Cycle Teams

This template streamlines the trial request process by collecting critical information upfront—provider count, billing complexity, specialty departments, and compliance requirements—so vendors can configure the most relevant demonstration and trial experience for your organization.

The form is optimized for revenue cycle directors, CFOs, and IT administrators who need to evaluate software solutions while ensuring all stakeholders are aligned on requirements and expectations.

#### How Paperform Supports Healthcare Operations

With Paperform, healthcare organizations can create professional, HIPAA-aware forms for vendor evaluations, staff onboarding, patient feedback, and operational workflows. The platform's conditional logic ensures that only relevant questions appear based on your organization's specific needs, while approval workflows route requests to the appropriate decision-makers.

**Automate your healthcare workflows with Stepper:** Once a trial request is submitted, use [Stepper](https://stepper.io) to automatically route approvals to revenue cycle directors, notify relevant departments, schedule implementation calls, and sync trial data to your CRM—all without manual handoffs.

**Secure agreements with Papersign:** When you're ready to move from trial to contract, use [Papersign](https://papersign.com) to transform your software agreements into secure eSignature documents, maintaining a complete audit trail from initial inquiry to signed contract.

This form template helps healthcare organizations move efficiently from evaluation to implementation, ensuring all stakeholders have visibility into software trials that impact revenue cycle performance.
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