Home
Catalog
Office Supplies
Business Forms & Record Keeping
General Forms
Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Salmon Sheets, 125 Forms Total

Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Salmon Sheets, 125 Forms Total

Out of Stock
SKU #
TAB14530
Mfr #
14530
Manufacturer
TABBIES
Description
Confidentially sign in your patients. Forms limit access to personal information as required by HIPAA. Patient signs in and waits to be called by name or number. Office staff removes numbered label strip with patient name and adheres it to patient chart to help improve record keeping. Once label strips have been removed, the patient information is now protected behind special backing paper. The sign-in form also provides confidential daily patient log. Forms numbered 1 - 23.
Add to Cart

Product Information

UPC:
084371145300
Country of Origin:
US
Dimensions:
11.625*8.5*1.75
Unit of Measure:
PK
Shipping Dimensions:
11.625*8.5*1.75
Quantity per UOM:
125
Weight:
4.95

Specifications

Global Product Type: Medical Admission Forms
Form Type Details: Medical Admission
Dated/Undated: Undated
Forms Per Page: 1
Format Indicator: Unbound
Copy Types: Two-Part Carbon
Color Family: Pink
Form Size: 8.5 x 11.63
Sheet Size: 8.5 x 11.63
Form Quantity (Total): 125
Principal Heading(s): Date,Please Print Name,Arrival Time,Appt. Time,Appointment With,New Patient,Any Changes Since Last Visit
Columns per Sheet: 6
Number of Entry Lines: 23
Paper Color(s): Salmon
Print and Ruling Color(s): Black
Numbering Color(s): Black
Product Biodegradability in Days: 0
Pre-Consumer Recycled Content Percent: 0%
Post-Consumer Recycled Content Percent: 0%
Total Recycled Content Percent: 0%
Special Features: Salmon Sheets
Country Of Origin: US
Carton Weight: 33 lbs.
Carton Pack Quantity: 6 PK
Pack Quantity: 125 EA
UPC: 084371145300
UNSPSC: 14111806

Bulk Order