Exhibit 10.40  Form of Promissory Notes payable to Dr. Schaffer and Mr.Pappajohn



THE SECURITIES  REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933,  AS AMENDED (THE "ACT"),  OR UNDER THE  SECURITIES  LAWS OF CERTAIN
STATES.  THESE  SECURITIES ARE SUBJECT TO  RESTRICTIONS ON  TRANSFERABILITY  AND
RESALE AND MAY NOT BE  TRANSFERRED  OR RESOLD EXCEPT AS PERMITTED  UNDER THE ACT
AND THE APPLICABLE STATE SECURITIES LAWS,  PURSUANT TO REGISTRATION OR EXEMPTION
THEREFROM.  HOLDERS  SHOULD  BE  AWARE  THAT  THEY MAY BE  REQUIRED  TO BEAR THE
FINANCIAL RISKS OF THIS INVESTMENT FOR AN INDEFINITE  PERIOD OF TIME. THE ISSUER
OF THESE  SECURITIES  MAY  REQUIRE AN  OPINION OF COUNSEL IN FORM AND  SUBSTANCE
SATISFACTORY TO THE ISSUER TO THE EFFECT THAT ANY PROPOSED TRANSFER OR RESALE IS
IN COMPLIANCE WITH THE ACT AND ANY APPLICABLE STATE SECURITIES LAWS.


                                                            PROMISSORY NOTE

August 21, 2000

Subject  to the terms and  conditions  of this Note,  and for good and  valuable
consideration  the  receipt  and  sufficiency  of which is hereby  acknowledged,
Patient  Infosystems,  Inc.,  a Delaware  corporation  (the  "Company"),  hereby
promises to pay to the order of John  Pappajohn  whose address is 2116 Financial
Center,  Des Moines,  Iowa 50309 (the  "Holder"),  the  principal  amount of One
Hundred Twenty-five Thousand Dollars ($125,000.00), plus simple interest accrued
on unpaid  principal  from the date of this Note  until paid at the rate of nine
and  one-half  percent  (9.5%)  per  annum.  This Note may be one of a series of
Promissory Notes  (collectively,  the "Bridge Notes")  identical in substance to
this Note except as to the Holder and principal amount.

The  following  is a  statement  of the  rights of the  Holder and the terms and
conditions to which this Note is subject,  to which the Holder, by acceptance of
this Note by its signature  below,  and the Company,  by issuance of this Notes,
agrees:






         1.  PAYMENT

                  (a) Obligation.  The outstanding principal under this Note and
the accrued interest thereon will be due and payable on demand.  All payments of
principal  and/or  interest  under this Note will be made at the  address of the
Holder set forth above or at such other  address as is provided by the Holder to
the Company in writing.
                  (b)  Prepayment.  The Company may prepay this Note in whole or
in part at any time without penalty.  Prepayments will be applied to accrued but
unpaid interest first and then to unpaid principal.  Any prepayments made by the
Company on any of the Bridge  Notes  will be made  simultaneously  on all Bridge
Notes in identical amount (if all Bridge Notes are of the same principal amount)
or an amount  prorated  among the Bridge Notes in  proportion  to the  principal
amounts of each  Bridge  Note (if the Bridge  Notes are in  different  principal
amounts).

         2.   TRANSFERABILITY.  This Note is not transferable.

         3.   GOVERNING  LAW.  This Note will be governed by and  construed  in
              accordance  with the laws of the  State of Iowa,  excluding  that
              body of law relating to conflict of laws.

         4.   WAIVER.  The Company hereby waives diligence, presentment, demand,
              protest and notice of dishonor.

         5.   COLLECTION  EXPENSES.  The Company promises and agrees to pay all
              costs of collection of this Note  including,  but not limited to,
              reasonable  attorneys'  fees,  paid or  incurred by the Holder on
              account  of such  collection,  whether  or not suit is filed with
              respect  thereto  and  whether  or not  such  costs  are  paid or
              incurred,  or to be paid or incurred,  prior to or after entry of
              judgment.


IN WITNESS WHEREOF, the Company has caused this Note to be issued as of the date
first written above.

                                            Patient Infosystems, Inc.

                                            ------------------------------
                                            By: Kent A. Tapper

ACCEPTED:


John Pappajohn

----------------------
By:  John Pappajohn