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Med-Pass® Confidential Privacy Sign-In Sheets

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Item # 901-38273
  Model # MPH953
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Med-Pass® White Confidential Sign-In Sheets
$7.49 /Pack 2 PAD = 1 PACK
 When you buy 4+
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Qty 1 4
Price $8.49 $7.49
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  • 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
Product Information 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
Miscellaneous Brand : Medical Arts Press
Weight Weight : 1.55 lbs. per Pack

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