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![](https://suppliesshops.gumlet.io/images/S-14541.jpg "Blue English/Spanish Confidential Patient Sign-In Forms, 8-1/2\")
Blue English/Spanish Confidential Patient Sign-In Forms, 8-1/2" x 11", 23 Peel Off Label Sign In Lines (125 Forms/Pack)
Item Number: S-14541
7 reviews
Pricing:
| Price per Pack of 125 | 2+ Packs | 5+ Packs | 10+ Packs | 20+ Packs |
| $69.21 | $64.65 | $62.51 | $61.68 | $60.57 |
| Volume Savings | 6.6% | 9.7% | 10.9% | 12.5% |
| Need 30+ Packs? Click here 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:
Make sure your healthcare facility or medical office is welcoming and accommodating with these Blue English/Spanish Confidential Patient Sign-In Forms from The Supplies Shops. Each of these HIPAA-compliant bilingual forms features room for 23 sign-ins. The forms also come with peel-off labels for each patient, which helps to ensure privacy when coming in for a visit. Whether you are signing in the patient in Spanish or English, they’ll feel more comfortable in your space when you take these extra steps for their comfort.
Once completed, you can remove the top sheet of the form to reveal a special backer with the complete log of the patient visits for the day. Each form features fields where patients can enter their name, arrival time, appointment time, appointment with, new patient check box and change of address, phone and insurance since the last visit.
- Blue English/Spanish Confidential Patient Sign-In Forms
- 8.5" x 11" forms
- 23 peel-off labels included to keep patient sign-in logs confidential
- Forms are bilingual (accommodating English and Spanish speaking patients)
- 125 forms per pack
- UPC Code: 8437114541
Specifications:
| ASIN: | B01MPXTYX5 | Background Color: | Blue | |
|---|---|---|---|---|
| Brand: | Tabbies | 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 | |
| Feature 9: | Bilingual Text: English and Spanish | Carbonless: | Yes | |
| Color: | Blue | Condition: | New | |
| Currency: | USD | Pre-Printed: | Yes | |
| Package Height: | 11 in | Package Weight: | 5.00 LB | |
| Package Width: | 8-1/2 in | Material: | Paper | |
| Country of Origin: | USA | Manufacturer Part Number: | 14541 | |
| 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 | |
| UPC: | 84371145416 |
| ASIN: | B01MPXTYX5 |
|---|---|
| Background Color: | Blue |
| Brand: | Tabbies |
| 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 |
| Feature 9: | Bilingual Text: English and Spanish |
| Carbonless: | Yes |
| Color: | Blue |
| Condition: | New |
| Currency: | USD |
| Pre-Printed: | Yes |
| Package Height: | 11 in |
| Package Weight: | 5.00 LB |
| Package Width: | 8-1/2 in |
| Material: | Paper |
| Country of Origin: | USA |
| Manufacturer Part Number: | 14541 |
| 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 |
| UPC: | 84371145416 |
Reviews:
5
Out of 5.0
Overall Rating
100%
of customers that buy this product give
it a 4 or 5-Star rating.
May 25, 2023 by Ruby R
“Great product.”
March 30, 2022 by Ruby R
“Great product”
January 2, 2020 by Ernest S
“Product as decribed”
