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Medical Arts Press® Dental Registration and History Form; Tooth Border
Item #: 901-20596
HIPAA compliant insurance authorization
Help ensure reimbursement and improve risk management
Collects printed name and relationship to patient
$53.99
1-3 pack
Save 3%
$51.99
4+ pack
Medical Arts Press® Comprehensive Examination Form
Item #: 901-21700
4-page document records clinical detail from a patient's comprehensive exam
Includes sections to record results from clinical tests
Includes top 25 ortho/neuro tests
$66.99
Per pack
$25.99
Per pack
Medical Arts Press® Registration Form Featuring Updates Section/Blue Wave
Item #: 901-33018
HIPAA compliant insurance authorization
Help ensure reimbursement and improve risk management
Collects printed name and relationship to patient
$24.59
Per pack
Medical Arts Press® Patient Information Update Form
Item #: 901-39072
Use with every patient
Printed on 24-lb. bond paper
Size: 8-1/2-in. x 11-in
$72.99
1 pack
Save 8%
$66.99
2+ pack
Quill Brand® Special-Size 3 Part Carbonless Forms, 9-1/2x5-1/2", 1,000/CT (9353)
Item #: 901-710837
Use Quill Brand special-size multi-part carbonless forms when you need multiple copies of the same form
Size: 9-1/2x5-1/2"; 8-1/2x5-1/2" without the carrier strips
3-part forms: white top sheet, canary-colored second sheet and pink third sheet
$139.99
Per carton
Medical Arts Press® Dental Registration Forms Featuring Updates Section, Unpunched, Sky Blue
Item #: 901-20558NP
Type of form: Dental registration form
250 per pack
Size: 8 1/2" x 11"
$55.99
1-3 pack
Save 3%
$53.99
4+ pack
TOPS 2023 1096 Tax Form, 1-Part, 25/Pack (L109625)
Item #: 901-5100Q
Use Form 1096 to submit the totals from information returns 1097, 1098, 1099, 3921, 3922, 5498, and W-2G to the Internal Revenue Service
A 1096 summary transmittal form must accompany each type of 1099 mailed to the IRS—due dates will vary by form
Single-part laser/inkjet compatible forms
$12.99
1-3 pack
Save 3%
$12.59
4+ pack
Medical Arts Press® Registration Forms without Updates Section ; Brush Silhouette
Item #: 901-21786
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Silhouetted toothbrush design welcomes patients
Printed in 1-color on two sides on 24-lb. white bond paper
$52.99
1 pack
Save 5%
$49.99
2+ pack
Medical Arts Press® Dental Chart Forms For Adult Patients; Information Update
Item #: 901-32429
Size: 8.5 X 11 inch
Form Printed On 1 Side
100 per package
$20.99
1-3 pack
Save 20%
$16.59
4+ pack
Quill Brand® Special-Size Multi-Part Carbonless Forms, 9-1/2 x 5-1/2", 3200 Sheets/Carton
Item #: 901-710833
Business paper is perfect for printing receipts that require two copies
Paper dimensions: 5.5"W x 9.5"L
Paper weight: 15 lbs.
$104.99
Per carton
Medical Arts Press® Replacement Day Sheet Forms; Bond, Format S1, 50 Forms/Pack (WJM11)
Item #: 901-20527
Replacement day sheet forms
Number of parts: One
50/Pack
$31.99
2+ pack
Medical Arts Press® Chiropractic Registration and History Forms, Botanical
Item #: 901-15164
Improved forms ensure reimbursement, improve risk management and document your clinical process
Areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity, onset, effect on daily activities, constancy and progression of symptoms
HIPAA-compliant insurance authorization
$79.99
1 pack
Save 6%
$74.99
2+ pack
Medical Arts Press® Dental Registration Forms Featuring Updates Section; Sky Blue, Spanish
Item #: 901-20743
HIPAA-compliant insurance authorization
Collects printed name and relationship to patient
Medication list requests correlating diagnosis
$56.99
1-3 pack
Save 3%
$54.99
4+ pack
Medical Arts Press® Podiatry Registration and History Forms, Love Your Feet
Item #: 901-15143
Colorful, user-friendly format
Combines thorough patient registration with specialized podiatric health history
Features personal and insurance information sections that enable you to set up your patient s account with ease
$44.99
1 pack
Save 4%
$42.99
2+ pack
Medical Arts Press® Chiropractic Forms; Travel Card
Item #: 901-21704
Set Up In Popular S.O.A.P. Format of Subjective, Objective, Assessment & Plans
Allows Carryover Of Chief Complaints & Treatment
Printed On Both Sides to Track Up to 20 Visits On One Card
$33.99
1 pack
Save 2%
$32.99
2+ pack
Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care
Item #: 901-15165
Forms ensure reimbursement, improve risk management and document your clinical process
Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity
Also includes areas for onset, effect on daily activities, and conditions
$80.99
Per pack
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$63.99
Per carton
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$35.99
Per pack
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 2,500 (CMS12LC)
Item #: 901-125557
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$108.99
Per pack
TOPS 2023 1099-MISC Tax Form with 3 1096 Forms, 4-Part, 50/Pack (6103Q)
Item #: 901-6103
As of 2023, you'll use Form 1099-MISC solely to report miscellaneous income to the IRS and your recipients, including rents, royalties and other types of income payments
For paper filers, the 2023 1099-MISC Copy B is due to your recipients by Feb. 1, 2023 (if box 8 and 10 are empty) or Feb. 16 (if filled); Copy A and 1096 must be mailed to the IRS by March 1, 2023; or e-file by March 31, 2023
5-Part 1099-MISC forms print 2 to a page on 25 micro perforated sheets with copies A, C, B, 2 & C
$27.99
1-3 pack
Save 3%
$26.99
4+ pack
Staples® Gummed Double-Window 4 3/16" x 9" Envelopes for Laser Forms; White 1,000/Box (381911/17045)
Item #: 901-381911
Business envelopes are suitable for many mailing projects
Made from white 24 lb. paper for durability
These envelopes measure 4 3/16"H x 9"L in size, providing enough space for your mail
$71.99
1-3 box
Save 4%
$68.99
4+ box
Custom Multi-Purpose Register Form, Classic Design, Small Format, 3 Parts, 1 Color Printing, 4" x 6", 500/Pack
Item #: 901-D6093
Use with your portable register to capture details on the spot - no hunting for a handy place to write
Compatible with 4 x 6" portable registers
7 lines enable most orders to fit on a single form