Description
This item is brand-new, factory sealed.
Confidentially sign in your patients. Forms limit access to personal information as required by HIPAA. Patient signs in waits to be called by name or number. Office staff removed 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. Form Size: 8 1/2 x 11 5/8; Number of Columns: 6; Forms Per Page: 1; Number of Entry Lines: 23.
Global Product Type:Forms-Attendance
Form Size:8 1/2 x 11 5/8
Number of Columns:6
Forms Per Page:1
Number of Entry Lines:23
Form Quantity:125
Sheet Size:8 1/2 x 11 5/8
Principal Heading(s):Date
Principal Heading(s):Please Print Name
Principal Heading(s):Arrival Time
Principal Heading(s):Appt. Time
Principal Heading(s):Appointment With
Principal Heading(s):New Patient
Principal Heading(s):Any Changes Since Last Visit
Layout:One Form per Sheet
Numbering:Preprinted Entry Lines
Copy Types:Carbonless Duplicate
Total Number of Entries per Book:2875
Paper Color(s):Green
Print and Ruling Color(s):Black
Numbering Color(s):Black
Finish:Label Stock
Quantity:125 per pack
Pre-Consumer Recycled Content Percent:0%
Post-Consumer Recycled Content Percent:0%
Total Recycled Content Percent:0%
Features
Certifications & Standards:
HIPAA
Assembly Required:
No
Recycled:
No
Country of Origin:
United States
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