Medical Arts Press® Dental Registration and Medical History Form; Spanish

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Item # 901-20586
  Model # 20586
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Medical Arts Press® Dental Registration and Medical History Form; Spanish
$31.50 /Pack 250 EACH = 1 PACK
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  • Form Type: Clinical
  • Format: Patient Registration Form
  • Sheet Size: 8-1/2" x 11"
Description
Obtains a medical history and personal, financial and insurance info. Has special sections for Parent info., insurance authorization, and 2 Medical History Updates. Printed in Spanish on 20-lb. bond. 250 sheets per package. Size: 8-1/2x11".
Specifications
Product Information Form Type : Clinical Format : Patient Registration Form
Sheet Size : 8-1/2" x 11" Form Size : 8-1/2" x 11"
Media Quantity : 250 Binding Type : Loose
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
Miscellaneous Country of Origin : USA Brand : Medical Arts Press
Weight Weight : 2.53 lbs. per Pack
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