Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per Pad
$6.01
5-9 pad
($0.06/EACH)
$3.35
40+ pad
($0.03/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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Sale
$6.01
5-9 pad
$0.06/EACH
$3.35
40+ pad
$0.03/EACH
100 EACH = 1 PAD
Buy more & save!
$8.59
$6.01
5 - 9 pad
$6.99
$4.89
10 - 19 pad
$6.49
$4.54
20 - 29 pad
$5.59
$3.91
30 - 39 pad
$4.79
$3.35
40 + pad
Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per 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"
