ComplyRight™ Patient Acknowledgment of Receipt of Privacy Practices Notice

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Item #: 901-A1354
  Model #: A1354
Brand: ComplyRight
ComplyRight™ Patient Acknowledgment of Receipt of Privacy Practices Notice
$29.99 Pack
 
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Product Highlights
  • Form Type: HIPAA
  • Format: Privacy Practices Form
  • Sheet Size: 8 1/2" x 11"
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Description
  • Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
  • HIPAA compliant
  • Size: 8 1/2" x 11"
  • 200 per pack
Specifications
Form Type : HIPAA Format : Privacy Practices Form Sheet Size : 8 1/2" x 11" Lines : No Lines
Form Size : 8-1/2" x 11" Media Quantity : 200 Sheets Binding Type : Wrapped Paper Color : White
Number of Parts : 1 Carbonless : No # Up Per Sheet/Page : 1 NCR Paper : No
Numbered : No Holes Punched : 2 Personalization : No Security Features : No
Brand : ComplyRight
Weight : 1.00 lbs. per Pack

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