A small part of your job is 100% of ours.
Good News! Ordering Just Got Easier! [ Collapse Deal ]

Medical Arts Press® Chiropractic Registration and History Forms, Balanced Rocks

See pricing info, deals and product reviews for Medical Arts Press® Chiropractic Registration and History Forms, Balanced Rocks at Quill.com. Order online today and get fast, free shipping for your business.
Item #: 901-35061
  Model #: 35061
Brand: Medical Arts Press
Not yet rated.Be the first to Write a Review
Medical Arts Press® Chiropractic Registration and History Forms, Balanced Rocks
$55.00 Pack
250 EACH = 1 PACK
 When you buy 8+
Buy more & save!
Qty 1 2-3 4-7 8+
Price $67.00 $62.00 $58.00 $55.00
Save 7% 13% 17%
Price per each: $0.27 $0.25 $0.23 $0.22
Lifetime 100% Satisfaction Guarantee
Delivery Date:
Go
Enter Zip Code
Parcel
Description
Comprehensive forms include areas for complete registration and history information. Includes general patient information, payment and insurance information, patient condition, and health history. Improved forms ensure reimbursement and improve risk management. Document your clinical process. Documents reason for visit, type of pain, site of pain or numbness, severity, onset, effect on daily activities, and constancy and progression of symptoms. HIPAA-compliant insurance authorization. Accident information alerts to different reimbursement source. Minor check box for adolescents plus school info. Check box for patients in non-married relationships. Flexible patient ID number accommodates social security number, your patient ID system, or health insurance claim number. Ten digit phone numbers throughout. Occupation, employer name, address, phone. Emergency and pharmacy contacts. Printed 2 sides on 24 lb. stock. Sold 250 per package.
  • Type of form: Registration and history form
  • 250 per pack
  • Size: 8 1/2" x 11"
  • Paper weight: 24 lbs
  • Binding type: Loose
  • Number of parts: 1
  • Comprehensive forms include areas for complete registration and history information, includes general patient information, payment and insurance information, patient condition, and health history
  • Improved forms ensure reimbursement and improve risk management, document your clinical process
  • Documents reason for visit, type of pain, site of pain or numbness, severity, onset, effect on daily activities, and constancy and progression of symptoms
  • Accident information alerts to different reimbursement source, minor check box for adolescents plus school info
  • Check box for patients in non-married relationships, flexible patient ID number accommodates social security number, your patient ID system, or health insurance claim number
  • Ten digit phone numbers throughout, occupation, employer name, address, phone, emergency and pharmacy contacts, printed 2 sides on 24 lbs. stock
Specifications
Business Forms Pack Size : 250 Envelopes : Envelopes Not Included True Color : White Width in Inches : 8.5
Brand : Medical Arts Press
Weight : 3.00 lbs. per Pack

Frequently Bought Together

Customers also viewed

Reviews
No Review
loadingLoading...