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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

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Price per
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$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 bilingual confidential patient sign-in sheet forms with peel off labels. The forms are bilingual accommodating English and Spanish speaking patients. 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. UPC Code: 8437114541

 ASIN:B01MPXTYX5 
 Background Color:Blue 
 Brand:Tabbies 
 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 
 Feature 9:Bilingual Text: English and Spanish 
 Carbonless:Yes 
 Carton Item Quantity:750 
 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 

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