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  • Forms limit access to personal information as required by HIPAA.
  • Once label strip is removed the patient information is now protected behind special backing paper.
  • Can be used as confidential daily patient log as well as sign-in sheet.

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

$90.00

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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.

  • Forms limit access to personal information as required by HIPAA.
  • Once label strip is removed the patient information is now protected behind special backing paper.
  • Can be used as confidential daily patient log as well as sign-in sheet.
Manufacturer # 14531
Form Type Details Medical Admission
Global Product Type Medical Admission Forms
Dated/Undated Undated
Forms Per Page 1
Form Size 8.5 x 11.63
Sheet Size 8.5 x 11.63
Format Indicator Unbound
Form Quantity (Total) 125
Copy Types Two-Part Carbon
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
Columns per Sheet 6
Number of Entry Lines 23
Paper Color(s) Blue
Color Family Blue
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 Blue Sheets
Details

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.

  • Forms limit access to personal information as required by HIPAA.
  • Once label strip is removed the patient information is now protected behind special backing paper.
  • Can be used as confidential daily patient log as well as sign-in sheet.
Attribute Name Attribute Value

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