Keep track of which patients come in to your healthcare facility or medical offices each day with these Blue Confidential Patient Sign-In Label Forms from The Supplies Shops. Each of these 8.5" x 11" HIPAA-compliant confidential patient sign-in sheets comes with 23 peel-off labels. This allows you to ensure that patient information remains confidential since it prevents other visitors from seeing details on the sign-in log. Once completed, you can remove the top portion to reveal the special backer, which will have a complete log of the patient visits for the day.

This form features a simple blue color background with fields for the following patient data: name, arrival time, appointment time, appointment with, new patient check box and a box to indicate a change of address, phone or insurance since the last visit.

• 8.5" x 11" form size
• 23 peel-off labels for confidentiality
• Backer records complete log of patients
• Blue color background
• Carbonless
• HIPAA compliant
• 125 per pack