Well, we send them electronically to the billing office and although space is now usually an issue, they bill for many providers and have a very large intake per day of claim forms. We are sending them the .xps files because even if the space is cheap, it is their space and I would like to take up as little as possible. Also, I have always had a certain dislike for the pdf format. Mainly that it is not easily edited by most people. If I were to send them a picture file they could edit it in Paint, or a word or Excel file they could edit in OpenOffice. Easy and cheap and well known. I have never found a good free alternative for editing, marking up, or anything else with pdf.