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Medical Arts Press® Dental Registration and History Form; Elegant Brush
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Medical Arts Press® Dental Registration and History Form; Elegant Brush

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Item # 901-15123
  Model # 15123
$53.99 Pack When you buy 8+
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Price $68.99 $63.99 $56.99 $53.99
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Product Information
Description
  • HIPAA compliant insurance authorization
  • Help ensure reimbursement and improve risk management
  • Collects printed name and relationship to patient
  • Medication lists requests correlating diagnosis
  • Screens for artificial heart valves, artificial joints, heart murmur, mitral valve prolapse and pacemaker
  • 250 sheets per film wrapped pack
  • Size: 8-1/2x11"
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