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Medical Arts Press Dental Registration and History Form, Welcome, Toothbrush, Teal Design, No Punch
Item #: 901-20582NP
Type of form: Registration and history form
250 per pack
Size: 8 1/2" x 11"
$55.19
Per pack
($0.22/EACH)
Medical Arts Press® 2-Part Optical Rx Blanks; Carbonless, 4x5-1/2"
Item #: 901-16029
2-part carbonless Rx blanks for eye-care field with copies that can be torn out or stored in book
Standard refill instructions
Specify state license and/or DEA numbers, if desired
Medical Arts Press® Take Home Instructions
Item #: 901-13870M
125 sheets per pack
Form size: 8-1/2" x 11"
$32.89
Per pack
($0.26/EACH)
Medical Arts Press® Dental Treatment Consent Form; 1-Sided
Item #: 901-20606
Provides your patient complete information about their treatment and its risks
Obtains written consent for your records
Just check off applicable conditions; patient reads explanation, initials and signs
$47.99
1 pack
($0.19/EACH)
Save 6%
$44.99
2+ pack
($0.18/EACH)
Medical Arts Press Dental Registration Forms Featuring Updates Section; Sky Blue, Spanish (20743)
Item #: 901-20743
Collects printed name and relationship to patient
Medication list requests correlating diagnosis
Screens for artificial heart valves, artificial joints, heart
$66.89
Per pack
($0.27/EACH)
Medical Arts Press® Registration Form Featuring Updates Section/Blue Wave
Item #: 901-33018
HIPAA compliant insurance authorization
Help ensure reimbursement and improve risk management
Collects printed name and relationship to patient
$20.59
Per pack
($0.08/EACH)
Medical Arts Press® Tamper-Resistant Secure Rx/2-Part Carbonless- Custom
Item #: 901-13553
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Quill Brand® 4-Column Columnar Book, 80 Pages, Blue Marble (18848/26517)
Item #: 901-217745
Columnar book for record keeping
Blue marble and made of paper
Includes 80 single-format pages, comes with four columns per page, quad-ruled
$25.49
Per each
Medical Arts Press Log of Hospital Visits, Pocket-sized, 1-Part
Item #: 901-20030
Updated with new 2010 consult codes and helpful chart on inside front cover
Make a check mark or write in the level of code for each patient visit
When patient is discharged, detach and give to billing - it's virtually foolproof
$70.09
1 pack
($7.01/EACH)
Save 5%
$65.99
2+ pack
($6.60/EACH)
Medical Arts Press® Medications Form, Purple FormFamily™
Item #: 901-20645
Comprehensive form helps you monitor medication dosages, quantity, frequency, and refills
Printed in blue ink on white 24-lb. bond paper
Predrilled holes on top or side of form
$23.99
1 pack
($0.10/EACH)
Save 12%
$20.99
2+ pack
($0.08/EACH)
Medical Arts Press Log of Hospital Visits, Pocket-Sized, 2-Part
Item #: 901-20029
Updated with New 2010 Consult Codes and Helpful Chart on Inside Front Cover
Make A Check Mark Or Write In The Level Of Code for Each Patient Visit
When Patient Is Discharged, Detach and Give to Billing - It S Virtually Foolproof
$44.99
1 pack
($4.50/EACH)
Save 6%
$41.99
2+ pack
($4.20/EACH)
Staples Record Book, 7.25"W x 11.75"H, Blue Marble, 300 Sheets/Book (886673)
Item #: 901-886673STP
Blue marble hardcover with silver foil stamped title
Includes 300 numbered pages, features blue and red lines
Overall dimensions: 7.25"W x 11.75"H
$51.99
Per each
Medical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Item #: 901-21786
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Silhouetted toothbrush design welcomes patients
Printed in 1-color on two sides on 24-lb. white bond paper
$56.29
Per pack
($0.23/EACH)
Medical Arts Press® Progress Notes, Includes Name, Sex, Birthdate and Page Number
Item #: 901-20541NP
Type of form: Progress note
250 per pack
Size: 8 1/2" x 11"
$52.99
Per pack
($0.21/EACH)
Medical Arts Press® Contact Lens Rx Blanks; 2-Part
Item #: 901-15586
Conforms to all new requirements of federal Fairness to Contact Lens Consumers Act (FCLCA)
Option to include customer warning regarding need for periodic eye exams (required in some states)
Black print on white stock
Medical Arts Press FormFamily Periodontal Exam Form (20607)
Item #: 901-20607
Type of form: Periodontal exam form
250 per pack
Size: 8 1/2" x 11"
$56.29
1 pack
($0.23/EACH)
Save 5%
$52.99
2+ pack
($0.21/EACH)
Medical Arts Press Dental Registration and History Form without Updates, Tooth Character
Item #: 901-20588
Type of form: Registration and history form
250 per pack
Size: 8 1/2" x 11"
$66.89
Per pack
($0.27/EACH)
Medical Arts Press Dental Registration Forms, 250/Pack (20558)
Item #: 901-20558NP
Type of form: Dental registration form
250 per pack
Size: 8 1/2" x 11"
$60.49
Per pack
($0.24/EACH)
Medical Arts Press Dental Registration and Medical History Form, Ledger Stock, 250/Pack (20128RL)
Item #: 901-20128MAP
Type of form: Dental registration and medical history form
250 per pack
Size: 8 1/2" x 11"
$57.29
Per pack
($0.23/EACH)
Medical Arts Press Eye Care Registration Form (20571)
Item #: 901-20571
Type of form: Registration form
250 per pack
Size: 8 1/2" x 11"
$66.89
Per pack
($0.27/EACH)
Staples Columnar Book, 50 Pages, Green (217885)
Item #: 901-217885
Columnar book is ideal for accounting and record keeping
Green-tinted paper with green and black lines
Includes 50 pages with 12 columns
$23.09
Per each
Medical Arts Press® Dental Treatment Record Form; 2-Sided
Item #: 901-20608
Ideal for practices that prefer not to record fees on their treatment notes
Form includes basic patient information
Two-sided with back of form ruled
$55.19
Per pack
($0.22/EACH)
Columnar Book, 6 Columns, 7.25" x 9.5", Blue Granite, 40 Sheets/Book (217752)
Item #: 901-217752
7 1/4" x 9 1/2"
80 pages per book
Quad ruled
$19.09
Per each
$20.59
Per pack
($0.08/EACH)
