Document wording can only be changed by an admin login. You're signed in, but this account doesn't have admin access.
This screen needs clinic-doc-wording.js and it isn't here. Refresh the page; if it keeps happening, your browser is showing a cached copy.
These blanks are filled in automatically when the document is made. If a blank isn't in the text, that detail simply won't be printed.
Saved. Now update the matching billing sheet in PracSuite so both say the same thing.