Online Book Payment form

Click here to access the online form

Please note:

• All fields are required to successfully submit your payment request.
• Please submit each invoice with a separate form.
• Payment will be made directly to the book vendor unless otherwise noted.

Instructions:

1. Add your name and email address.
2. Select the name of your location in the dropdown menu. If you start typing the name in the box, it should automatically scroll to it.
3. Type in the total amount due from the invoice.
   
   
4. Select the vendor name from the invoice.
   
5. Attach the invoice. Acceptable formats include pdf, doc, jpg and png.
6. Please answer the next two questions. Ensure that you have attached all pages and that it is the actual invoice from the vendor rather than a packing slip, email confirmation, etc.
   
7. The Site Coordinator (or Physician Champion) must sign before submitting the form.

If you have any questions, please reach out to Denae at denae.hart@kansasaap.org.