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Blue Confidential Patient Sign-In Label Forms, 8-1/2" x 11", 23 Peel Off Adhesive Sign In Lines (125 Forms per Pack)

Item Number: S-14531

Pricing:

Price per
Pack of 125
2+
Packs
5+
Packs
10+
Packs
20+
Packs

$37.49 $37.19$36.59$35.85$35.39

Volume Savings0.8%2.4%4.4%5.6%

Need 30+ Packs? Contact us for Pricing

  • HIPPA Compliant (HIPPA Privacy Rule, Section 164.502)
  • Second Sheet is a complete record of all patients seen that day
  • Option to call patients by name or number
  • Carbonless
  • Patient Privacy Sign-In Sheet

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Description:

HIPAA Compliant confidential patient sign-in sheet forms with peel off labels. 8.5" x 11" forms with 23 peel off labels used to keep patient sign in logs confidential. Once completed the special backer has a complete log of the patient visits for the day. Blue color background with fields for name, arrival time, appointment time, appointment with, new patient check box and change of address, phone and insurance since the last visit.

Specifications:
ASIN:B00NBB6UCMBackground Color:Blue
Brand:TabbiesFeature 6:A special back printing prevents writing from showing on the liner
Feature 7:Printing on the liner directs patients to sign the next lineFeature 8:125 Sheets / Pack
Carbonless:YesCarton Item Quantity:750
Color:BlueCondition:New
Currency:USDPre-Printed:Yes
Package Height:11 inPackage Weight:5.00 LB
Package Width:8-1/2 inMaterial:Paper
Country of Origin:USAManufacturer Part Number:14531
Number of Items:125Paper Size:Letter
Sheet Length:11 inSheet Size:8-1/2 x 11 in
Sheet Width:8-1/2 inShips in:1 to 3 Business Days (Plus time in transit)
Size:8-1/2 x 11 inText Color:Black
UPC:84371145317
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