Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
$57.29
Per pack
Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
Item #:
901-20596
Model #:
20596
Brand:
Medical Arts Press
(3 reviews)
Item #:
901-20596
$57.29
Per pack
1 PACK = 250 EACH
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Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
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
Brand
Medical Arts Press
Form Size
8 1/2" x 11"
Length in Inches
11
True Color
White
Width in Inches
8.5
