-----BEGIN PRIVACY-ENHANCED MESSAGE-----
Proc-Type: 2001,MIC-CLEAR
Originator-Name: webmaster@www.sec.gov
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 TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB
MIC-Info: RSA-MD5,RSA,
 Gr4WLtml/+39FvDUZpR2qsjjWKVMgvFpEw89FdL/GJwk1hodXiWbsrPWFBD0+Nr7
 NMUjAWVk2VMZdsItj5alyw==

<SEC-DOCUMENT>0001005477-04-003059.txt : 20040823
<SEC-HEADER>0001005477-04-003059.hdr.sgml : 20040823
<ACCEPTANCE-DATETIME>20040823133726
ACCESSION NUMBER:		0001005477-04-003059
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20040813
FILED AS OF DATE:		20040823
DATE AS OF CHANGE:		20040823

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			JUVONEN RONALD
		CENTRAL INDEX KEY:			0001137058

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-50082
		FILM NUMBER:		04991410

	BUSINESS ADDRESS:	
		STREET 1:		C/O DOWNTOWN ASSOCIATES
		STREET 2:		674 UNIONVILLE ROAD, SUITE 105
		CITY:			KENNETT SQUARE
		STATE:			PA
		ZIP:			19348

	MAIL ADDRESS:	
		STREET 1:		C/O DOWNTOWN ASSOCIATES
		STREET 2:		674 UNIONVILLE ROAD, SUITE 105
		CITY:			KENNETT SQUARE
		STATE:			PA
		ZIP:			19348

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			IMPAC MEDICAL SYSTEMS INC
		CENTRAL INDEX KEY:			0001026448
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-PREPACKAGED SOFTWARE [7372]
		IRS NUMBER:				943109238

	BUSINESS ADDRESS:	
		STREET 1:		100 W EVELYN AVE
		CITY:			MOUNTAIN VIEW
		STATE:			CA
		ZIP:			94041
		BUSINESS PHONE:		6506238800

	MAIL ADDRESS:	
		STREET 1:		100 W EVELYN AVE
		CITY:			MOUNTAIN VIEW
		STATE:			CA
		ZIP:			94041
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>edgar123.xml
<DESCRIPTION>FORM 3
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0202</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2004-08-13</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0001026448</issuerCik>
        <issuerName>IMPAC MEDICAL SYSTEMS INC</issuerName>
        <issuerTradingSymbol>IMPC</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001137058</rptOwnerCik>
            <rptOwnerName>JUVONEN RONALD</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O DOWNTOWN ASSOCIATES, L.L.C.</rptOwnerStreet1>
            <rptOwnerStreet2>674 UNIONVILLE ROAD, SUITE 105</rptOwnerStreet2>
            <rptOwnerCity>KENNETT SQUARE</rptOwnerCity>
            <rptOwnerState>PA</rptOwnerState>
            <rptOwnerZipCode>19348</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>1</isTenPercentOwner>
            <isOther>0</isOther>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock, par value $.001</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>1203200</value>
                    <footnoteId id="F1"/>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                    <footnoteId id="F1"/>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By partnerships and limited liability company</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <footnotes>
        <footnote id="F1">The securities reported herein are held by Downtown Associates I, L.P., Downtown Associates II, L.P., Downtown Associates III, L.P., Downtown Associates IV, L.P., Downtown Associates V, L.P. (collectively referred to as the &quot;Downtown Funds&quot;).  The reporting person's indirect interest in the securities held by the Downtown Funds is limited to his pecuniary interest, if any, in the Downtown Funds.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Ronald J. Juvonen</signatureName>
        <signatureDate>2004-08-23</signatureDate>
    </ownerSignature>
</ownershipDocument>

</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
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