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Medical Arts Press® Dental Registration and History Forms without Updates; Graphics, No Imprint
Item #: 901-21764
Model #: 21764RL
Brand: Medical Arts Press
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| Qty | 1 | 2-3 | 4-7 | 8+ |
| Price | $78.99 | $72.99 | $64.99 | $61.99 |
| Qty. Savings | 7% | 17% | 21% | |
| Price per each: | $0.32 | $0.29 | $0.26 | $0.25 |
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Description
- Colorful form gathers important information you need for your records, quickly and easily
- Includes sections for patient and insurance information, history, and authorization and release
- Printed both sides on 24-lb. bond
- 250 sheets per package
- Size: 8-1/2x11
- To view an enlarged sample of this form Click Here
Specifications
| Brand : Medical Arts Press | Chart and Form Type : Standard Patient Registration Form | Charts Paper Weight (Lbs) : 24 | Color Family : Multicolor |
| Customizable : No | Height in Inches : 11" | Number of Pages : 250 | Paper Type : Bond |
| Series or Collection : Dental | Speciality Use : Dental | True Color : Multicolor | Used For : Registration and History Form |
| Width in Inches : 8.5" | |||
| Weight : 34.00 lbs. per Pack |
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