5
Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Blue Sheets, 125 Forms Total
- Product Type :
- Item # : TAB14531
-
Stock Check
Quick Overview
- 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.
Add Line NoteDescription
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.
General Information
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
Blue
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)
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
Country of Origin
US
Carton Weight
33.0
Carton Pack Quantity
6/PK
Pack Quantity
125
UPC
084371145317
UNSPSC
14111806
Shipping Weight & Item Dimensions
Weight
4.95 lbs
Length
11.625 in
Height
1.75 in
Width
8.5 in
