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Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care

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Item #: 901-15165
  Model #: 15165
Brand: Medical Arts Press
Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care
$63.99 Pack
When you buy 8+
250 EACH = 1 PACK
or
$77.99 Pack
When you buy 1
Buy more & save!
Qty 1 2-3 4-7 8+
Price $77.99 $71.99 $67.99 $63.99
Qty. Savings 7% 12% 17%
Price per each: $0.31 $0.29 $0.27 $0.26
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Description
  • Forms ensure reimbursement, improve risk management and document your clinical process
  • Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity
  • Also includes areas for onset, effect on daily activities, and conditions
  • HIPAA-compliant insurance authorization
  • Accident information alerts to different reimbursement source
  • Check box for minors and space for school information
  • Flexible patient ID number accommodates social security number, your patient ID system, or health insurance claim number
  • Occupation, employer name, address and phone; emergency and pharmacy contacts
  • Full color, Printed 2 sides on 24 lb. stock
  • Sold 250 forms per package
Specifications
True Color : White Width in Inches : 8.5 Business Forms Pack Size : 250 Envelopes : Envelopes Not Included
Brand : Medical Arts Press Customizable : No
Weight : 2.92 lbs. per Pack

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