The Estimates tab on the patient profile provides a centralized view of all estimates associated with that patient. From the Estimates tab, you can preview past estimates, review active estimates, check approval and import status, and create new estimates. Signed estimates are tracked over time, making it easy to reference past client approvals.
Navigate to: Admin > Clients/Patients > Patient Profile > Estimates tab
What You Need to Know
Approving an estimate does not automatically create an invoice.
After an estimate is approved, it must still be imported into an open SOAP and transferred into the treatment plan before any items can be invoiced.
Estimates created inside a Comprehensive SOAP are permanently tied to that SOAP.
These estimates cannot be moved or imported into a different SOAP, even if they are signed or approved.
An estimate can only be imported into a single SOAP.
If the Import to SOAP option is unavailable, the estimate may already be in use by another SOAP. Check the Imported to SOAP column on the patient's Estimates tab to confirm.
Once an estimate is approved, transferred, or associated with a locked SOAP, some editing and reversal options are no longer available.
Before approving or transferring an estimate, verify that the SOAP and all line items are correct. Reverse import is not available if the SOAP is locked or if items have already been transferred to the treatment plan.
The Rx toggle on each estimate line item controls where that item lands after transfer.
Items marked as Rx transfer to the SOAP's Rx tab. Items not marked as Rx transfer to the Plan (P) area for administration confirmation.
Where to Create an Estimate
Estimates can be created from two places in Shepherd. Choosing the right starting point affects what you can do with the estimate later.
Use the Patient Page when the estimate is for future care, pre-visit planning, or when the client needs to approve costs before the appointment.
Patient Page estimates can be imported into an open Comprehensive SOAP at any time.
Use the Comprehensive SOAP when the estimate is for the current visit.
Estimates created inside a SOAP are permanently tied to that SOAP and cannot be moved to another.
Creating an Estimate from the Patient Page
Admin > Clients/Patients > [Search for and select client] > Patient Profile > Estimates tab
This method is best for preparing estimates before an appointment or for upcoming recommended care. Clients can review and approve these estimates in advance.
Navigate to the patient profile. Go to Clients/Patients, search for the client, and select the patient.
Start a new estimate. Click the three-dot action icon in the upper right corner and select Add Estimate, or go to the Estimates tab and click + Add Estimate.
Add items using the search bar. You can add treatments, products, medications, vaccinations, and services.
Click Save once all items are added.
Request client approval. Approval is required to transfer estimate items into a SOAP treatment plan or Rx section.
Creating an Estimate within a Comprehensive SOAP
This method is best for same-day visits, immediate approvals, or last-minute additions to the treatment plan. Estimates created within a Comprehensive SOAP are permanently tied to that specific SOAP and cannot be moved or imported into another SOAP, even if signed or approved.
Navigate to the patient's SOAP. Begin a new Comprehensive SOAP or open an existing active visit.
In the SOAP Summary section, select Add Estimate.
You also have the option to import a previously created Patient Page estimate directly into the SOAP. Estimates imported this way cannot be unimported from the SOAP.
If you started a new estimate, use the search bar to add treatments, products, and services relevant to the patient's visit.
Save the estimate before sharing it with the client. You can present it to the client immediately for approval or return to it later for adjustments.
Once the estimate is approved, click Add Products to Plan or Rx to transfer items to the SOAP treatment plan.
Client approval or manual approval is required before items can be transferred from an estimate to the treatment plan or Rx section of a SOAP.
Importing an Estimate into a SOAP
Admin > Clients/Patients > Patient Profile > Estimates tab
If you created a Patient Page estimate in advance and need to bring it into an active Comprehensive SOAP, you can import it from the Patient Profile or from within the SOAP itself. An active, open SOAP must exist before you can import an estimate.
From the Patient Page
Navigate to the patient profile and open the Estimates tab.
Click the three-dot action icon to the right of the estimate row.
Select Import to SOAP.
If the Import to SOAP option is not visible, the estimate may already be imported into another SOAP. Check the Imported to SOAP status column to confirm.
The estimate will import into the active open SOAP by default. An estimate can only be imported into a single SOAP.
From within the Comprehensive SOAP
Open the SOAP and navigate to the Summary tab.
Locate the Estimates section and click inside the Import Estimate search bar.
Select the estimate you want to import. Any available Patient Page estimates will appear in the list.
If the import option is greyed out, ensure the SOAP note is open and not locked.
An estimate can only be imported into a single SOAP. Estimates imported into a Basic (Quick) SOAP remain functional if that SOAP is later converted to a Comprehensive SOAP.
How to Reverse an Accidental Import
If you imported an estimate into the wrong SOAP, you can initiate a reversal from three locations:
The Patient Profile > Estimates tab
The SOAP Summary tab > Estimates section
The SOAP Summary tab > inside the estimate itself
Look for the reverse arrow icon or the Reverse Import action option in the estimate's action menu.
Reverse import is not available if any of the following conditions are true:
The SOAP is locked.
Items from the estimate have already been transferred into the treatment plan.
Once any of these conditions apply, the import cannot be reversed.
Customizing Your Estimate
Min and Max Quantity Ranges
Min and max quantity fields in estimates accept a value of 0, which creates an open-ended range with no upper or lower restriction. This allows for more flexible treatment estimates without requiring multiple estimate versions for the same service.
Min and max ranges can also be set independently for individual items within static bundles, allowing for more tailored estimates at the bundle level.
Adding Prescriptions (Rx) to an Estimate
To add prescription items to an estimate:
Search for and add the prescription medication as you would any other product or service.
Select the Rx toggle located to the right of the item's name in the item row.
Items within static bundles can be marked as Rx independently.
Items marked as Rx transfer to the Rx tab of the SOAP once the estimate is approved and added to the SOAP plan. Items not marked as Rx transfer to the Plan (P) area for final administration confirmation. If a prescription item lands in the Plan area instead of the Rx tab, the Rx toggle was not selected on that item in the estimate.
Estimate Templates and Bundles
Shepherd does not currently offer global estimate templates that can be created once and applied to any patient. Estimates are created for a specific patient and, depending on where they are created, may also be tied to a specific SOAP.
For repeatable estimate workflows, use bundles as reusable building blocks. A bundle is a group of commonly used products, services, treatments, medications, or procedure items that can be added to an estimate instead of rebuilding the same set of items from scratch. Bundles help standardize common treatment plans while still allowing each estimate to be reviewed and adjusted for the individual patient.
Common examples include dental packages, surgery packages, sedation packages, wellness packages, and pre-anesthetic plans.
Bundles are created and managed from Admin > Products > Bundles.
Once a bundle is created, it can be added to any estimate. Static bundles support independent min/max quantity ranges for individual items, and items within static bundles can be marked as Rx independently. Items marked as Rx transfer to the SOAP's Rx tab once the estimate is approved and added to the SOAP plan. Non-Rx items transfer to the Plan (P) area.
Estimate Presentation
Shepherd controls what clients see on a presented or printed estimate separately from what your internal team sees. The following behaviors are expected and are not printing errors.
Discounts
Discount fields are hidden from the client-facing estimate when no discounts are included on the estimate. These fields remain visible to your internal team in the Shepherd interface for manual adjustment purposes.
Default Item Presentation
If a product is configured in your Admin product settings to not print on invoices or estimates, that item will not appear in the rows presented to the client. The item remains visible to your internal team within the Shepherd interface. To configure an item as internal-only by default, the item must have a $0 selling price. This setting is useful for products added for inventory or record management purposes that do not need to be presented to or discussed with the client.
Handling Locked SOAPs
Notes and lab results cannot be added directly to a locked SOAP. To add notes after a SOAP is locked, add a general note to the patient's medical history instead. To avoid this limitation for lab work, use the Lab Pending status while waiting for lab results.
Unconfirmed treatments are hidden in locked SOAPs. To view pending treatments, unlock the SOAP and confirm the treatments.
Locked SOAPs are removed from the active dashboard but remain visible in the patient's chart. This allows the record to remain accessible for incoming lab results without appearing in the active dashboard queue.
Getting Client Approval
Shepherd offers three ways to get client approval on an estimate. Save the estimate before initiating any of these approval methods.
Send for eSignature
Send for eSignature generates a URL link that can be shared with the client via email or SMS. The client reviews and signs the estimate remotely without needing to be present in the clinic. This method is best when requesting approval before a visit, when the client is not available in person, or when your clinic does not have a mobile workstation device.
After saving the estimate, select Send for eSignature to use this workflow.
Request In-Person Signature
Request In-Person Signature opens an electronic signature box directly on the clinic workstation device. The client signs on-screen without requiring a shared link. This method is best when the client is present at the clinic.
After saving the estimate, select Request Client Signature to use this workflow.
Manual Approval
Manual Approval allows a staff member to approve or decline an estimate on the client's behalf when a client signature is not possible.
After saving the estimate, select Manual Approve/Decline to use this workflow.
Turning an Approved Estimate into an Invoice
Approving an estimate does not automatically generate an invoice. To convert an approved estimate into invoiceable charges, complete the following steps:
Confirm the estimate is approved.
Confirm the estimate is imported into an open Comprehensive SOAP.
In the SOAP, click Add Products to Plan or Rx to transfer the approved items to the treatment plan.
Confirm or administer items in the treatment plan as needed.
Proceed through the normal SOAP invoicing workflow to generate the invoice.
If the Add Products to Plan or Rx button is unavailable, confirm that the estimate has been approved and that the SOAP is open and not locked.
Frequently Asked Questions
Why can't I import an estimate into a SOAP?
An estimate cannot be imported if there is no active, open SOAP available, or if the estimate has already been imported into another SOAP. Check the Imported to SOAP column on the patient's Estimates tab to see if the estimate is already associated with a SOAP. If the import option is greyed out, confirm that the SOAP note is open and not locked.
Why are items missing when I print or present the estimate?
Items configured in your Admin product settings to not print on invoices or estimates will not appear in the client-facing version of the estimate. This is expected behavior and not a printing error. These items remain visible to your internal team in the Shepherd interface. Discount fields are also hidden from the client view when no discounts are present on the estimate.
Why did my prescription item transfer to the treatment plan instead of the Rx tab?
Prescription items transfer to the Rx tab only when the Rx toggle is selected for that item on the estimate. If the Rx toggle was not selected, the item transfers to the Plan (P) area instead. Check the Rx toggle on each prescription line item in the estimate before transferring to ensure items route to the correct SOAP section.
Can I use estimates as templates? What are bundles?
Shepherd does not currently have global estimate templates that can be created once and reused for every patient. For repeatable estimate workflows, use bundles instead. A bundle is a reusable group of products, services, treatments, or medications that can be added to an estimate so your team does not need to rebuild the same set of items from scratch each time. Bundles are created and managed from Admin > Products > Bundles.