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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
$35.99 Pack
When you buy 8+
250 EACH = 1 PACK
or
$49.99 Pack
When you buy 1
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Qty 1 2-3 4-7 8+
Price $49.99 $44.99 $41.99 $35.99
Qty. Savings 10% 16% 28%
Price per each: $0.20 $0.18 $0.17 $0.14
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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
Brand : Medical Arts Press Color Family : White Customizable : No Number of Pages : 250
True Color : White Used For : Medical History
Weight : 3.08 lbs. per Pack

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