Med-Pass® Confidential Privacy Sign-In Sheets

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Item #: 901-38273
  Model #: MPH953
Brand: Medical Arts Press
Med-Pass® Confidential Privacy Sign-In Sheets
$7.49 Pack
2 PAD = 1 PACK
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Qty 1-3 4+
Price $8.49 $7.49
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Price per pad: $4.25 $3.75
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Product Highlights
  • Form Type: Clinical
  • Format: Sign In Sheet
  • Sheet Size: 8-1/2" x 11"
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Description
Designed for use with Confidential Patient Sign-in Log Holder 38275. Asks patients for arrival time, appointment time, name, check if new patient, any change in address, phone or insurance coverage. 50 sheets per pad/21 sign-in lines per sheet. Can also be used without log holder for practices not using a confidential sign-in process.
  • For Use with Log Holder, Item #38275
Specifications
Form Type : Clinical Format : Sign In Sheet Sheet Size : 8-1/2" x 11" Lines : 21
Form Size : 8-1/2" x 11" Media Quantity : 100 Binding Type : Padded Paper Color : White
Number of Parts : 1 Carbonless : No # Up Per Sheet/Page : 1 NCR Paper : No
Numbered : No Holes Punched : None Personalization : No Security Features : No
Brand : Medical Arts Press
Weight : 1.55 lbs. per Pack

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