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Medical Arts Press® Registration and History Forms; Purple Marble

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Item #: 901-20629
  Model #:
Brand: Medical Arts Press
Medical Arts Press® Registration and History Forms; Purple Marble
$37.99 Pack
250 EACH = 1 PACK
 When you buy 8+
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Qty 1 2-3 4-7 8+
Price $48.99 $44.99 $40.99 $37.99
Save 8% 16% 22%
Price per each: $0.20 $0.18 $0.16 $0.15
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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
Weight : 3.20 lbs. per Pack

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