Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
$16.79
5-9 pad
($0.17/EACH)
Save 41%
$9.99
40+ pad
($0.10/EACH)
Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
Item #:
901-QFN132131R
Model #:
7QGFM132131R
Brand:
Quill Custom Print
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$16.79
5-9 pad
$0.17/EACH
41% off
$9.99
40+ pad
$0.10/EACH
100 EACH = 1 PAD
Buy more & save!
Qty. savings
$16.79
5 - 9 pad
11%
$14.99
10 - 19 pad
20%
$13.49
20 - 29 pad
30%
$11.79
30 - 39 pad
41%
$9.99
40 + pad
Save up to an extra 10% on your order, See your savings with our calculator.
Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
Frequently bought together
Item #: 901-QFN132131R
$16.79
5-9 pad
($0.17/EACH)
41% off
$9.99
40+ pad
($0.10/EACH)
$83.95
+
+
Item #: 901-QFN131091R
$8.59
5-9 pad
($0.09/EACH)
44% off
$4.79
40+ pad
($0.05/EACH)
$42.95
Total
$169.85
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Description
Professional note certifies that a patient under your care has been totally or partially incapacitated for a period of time.
- For certification of care
- 8-1/2" W x 5-1/2" L
- White 20# text stock; printed in black ink
- 100 sheets per pad, order in quantities of 5 pads
- Padded at the top
Specifications
# Up Per Sheet/Page
1
Binding Type
Padded
Brand
Quill Custom Print
Carbonless
No
Color
White
Customizable
Yes
Form Size
5-1/2" x 8-1/2"
Form Type
Insurance
Format
Medical Chart
Holes Punched
No
Lines
7
Media Quantity
100
NCR Paper
No
Number of Parts
1
Numbered
No
Package Quantity
100 per Pad
Personalization
Yes
Security Features
No
Sheet Size
5-1/2" x 8-1/2"
