Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per Pad
$9.29
5-9 pad
(
$0.09/EACH
)
Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per Pad
Item #:
901-QFN131491R
Model #:
7QGFM131491R
Brand:
Quill Custom Print
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Product details
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- For insurance authorizations
- 5-1/2" W x 4" L
- White 20# text stock; printed in black ink
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$9.29
5-9 pad
(
$0.09/EACH
)
100 EACH = 1 PAD
Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per Pad
Buy more & save!
Extra 43% off on 40+ units
Qty. savings
Per pad
20%
$7.39
10 - 19 pad
26%
$6.89
20 - 29 pad
37%
$5.89
30 - 39 pad
43%
$5.29
40 + pad
Description
Professional note pad provides a quick and easy way to obtain patient authorization for a variety of insurance issues.
- For insurance authorizations
- 5-1/2" W x 4" 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
4" x 5-1/2"
Form Type
Insurance
Format
Medical Authorization Form
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
4" x 5-1/2"
