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To order by phone or for product assistance Call Toll Free: 855-632-8520
To order by phone or for product assistance Call Toll Free: 855-632-8520

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


Price per
Pack of 125

$37.49 $37.19$36.59$35.85$35.39

Volume Savings0.8%2.4%4.4%5.6%

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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.

 Background Color:Blue 
 Feature 1:HIPPA Compliant (HIPPA Privacy Rule, Section 164.502) 
 Feature 2:Second Sheet is a complete record of all patients seen that day 
 Feature 3:Option to call patients by name or number 
 Feature 4:Carbonless 
 Feature 5:Patient Privacy Sign-In Sheet 
 Feature 6:A special back printing prevents writing from showing on the liner 
 Feature 7:Printing on the liner directs patients to sign the next line 
 Feature 8:125 Sheets / Pack 
 Carton Item Quantity:750 
 Package Height:11 in 
 Package Weight:5.00 LB 
 Package Width:8-1/2 in 
 Country of Origin:USA 
 Manufacturer Part Number:14531 
 Number of Items:125 
 Paper Size:Letter 
 Sheet Length:11 in 
 Sheet Size:8-1/2 x 11 in 
 Sheet Width:8-1/2 in 
 Ships in:1 to 3 Business Days (Plus time in transit) 
 Size:8-1/2 x 11 in 
 Text Color:Black 


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