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Medical Arts Press® Registration and History Forms; Purple Marble
Item #: 901-20629
Model #:
Brand: Medical Arts Press
Buy more & save!
| Qty | 1 | 2-3 | 4-7 | 8+ |
| Price | $58.99 | $53.99 | $49.99 | $45.99 |
| Qty. Savings | 8% | 15% | 22% | |
| Price per each: | $0.24 | $0.22 | $0.20 | $0.18 |
Lifetime Warranty
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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 | Chart and Form Type : Standard Patient Registration Form | Color Family : Purple | Customizable : No |
| Height in Inches : 11" | Number of Pages : 250 | Series or Collection : General Health | Speciality Use : General Practice |
| True Color : Purple | Used For : Registration and History Form | Width in Inches : 8.5" | |
| Weight : 30.00 lbs. per Pack |
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