ComplyRight™ Patient Acknowledgment of Receipt of Privacy Practices Notice

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Item # 901-A1354
  Model # A1354
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ComplyRight™ Patient Acknowledgment of Receipt of Privacy Practices Notice
$29.99 /Pack
 
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  • Form Type: HIPAA
  • Format: Privacy Practices Form
  • Sheet Size: 8 1/2" x 11"

Frequently Bought Together

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
Product Information 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
Miscellaneous Brand : ComplyRight
Weight Weight : 1.00 lbs. per Pack

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