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Medical Arts Press® Dental Registration and History Form; Tooth Border

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Item #: 901-20596
  Model #: 20596
Brand: Medical Arts Press
Medical Arts Press® Dental Registration and History Form; Tooth Border
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Qty 1 2-3 4-7 8+
Price $41.99 $37.99 $34.99 $29.99
Qty. Savings 9% 16% 28%
Price per each: $0.17 $0.15 $0.14 $0.12
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Description
  • HIPAA compliant insurance authorization
  • Help ensure reimbursement and improve risk management
  • Collects printed name and relationship to patient
  • Medication lists requests correlating diagnosis
  • Screens for artificial heart valves, artificial joints, heart murmur, mitral valve prolapse and pacemaker
  • 250 sheets per film wrapped pack
  • Size: 8-1/2x11"
Specifications
True Color : White Width in Inches : 8.5 Envelopes : Envelopes Not Included Business Forms Pack Size : 250
Brand : Medical Arts Press Customizable : No
Weight : 3.11 lbs. per Pack

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