ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$67.99
Per pack
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #:
901-398026
Model #:
A1354
Brand:
ComplyRight
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Description
ComplyRight Patient acknowledgment of receipt of privacy practices notice measures 8 1/2" x 11".
ComplyRight Patient acknowledgment of receipt of privacy practices notice is attorney approved form acknowledging patient's information to be released to an authorized third party. Notice measures 8 1/2" x 11".
- Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
- HIPAA compliant
- Size: 8 1/2" x 11"
- Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
- HIPAA compliant
Specifications
Brand
ComplyRight
Form Size
8 1/2" x 11"
Length in Inches
11
Medical Form Pack Size
200
Medical Form Type
Privacy Practice
Pack Qty
1
Series or Collection
Patient Acknowledgment of Receipt
True Color
White
Width in Inches
8.5