Medical Arts Press® Registration Form Featuring Updates Section/Blue Wave
        Item #:
        901-33018
    
        
            Model #:
            
        
            
            Brand:
            Medical Arts Press
        
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                         $20.59 
                    
                        Per  pack
                                  $0.08/EACH  
                
                            250 EACH = 1 PACK
                                
                        
                
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                            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"
- To view an enlarged sample of this form Click Here
Specifications
        
                    Brand
                
                
                    Medical Arts Press
                
                
                    Length in Inches
                
                
                    11
                
                
                    Pack Qty
                
                
                    1
                
                
                    Width in Inches
                
                
                    8.5
                
    