Page 3 of Forms
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ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Item #: 901-24614845
Designed for hospitals to file a medical claim with the patient's insurance carrier
One-part health insurance forms
Printed with OCR dropout red ink on white paper
$41.99
Per each
Medical Arts Press Dental Consent Form; Rainbow FormFamily (10039)
Item #: 901-10039
100 sheets per package
Size: 8-1/2" x 11"
Form Printed on 1 Side
$27.59
Per pack
($0.28/EACH)
Medical Arts Press® Medications Form, Purple FormFamily™
Item #: 901-20645
Comprehensive form helps you monitor medication dosages, quantity, frequency, and refills
Printed in blue ink on white 24-lb. bond paper
Predrilled holes on top or side of form
$23.99
1 pack
($0.10/EACH)
Save 12%
$20.99
2+ pack
($0.08/EACH)
Medical Arts Press® Chiropractic Registration and History Form, 250 Forms/Pack (21701)
Item #: 901-21701
Forms ensure reimbursement, improve risk management and document your clinical process
Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness
Also features areas for severity, onset, effect on daily activities, and co
$67.89
Per pack
($0.27/EACH)
ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)
Item #: 901-24602228
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$45.99
1-2 each
Save 6%
$42.99
3+ each
ComplyRight 2025 W-2 Blank Tax Form, 4-Up (Horizontal), with Backer Instructions, Pack of 500 Forms
Item #: 901-24650554
Form W-2 provides wage and income information to your employees, the SSA, the IRS, and state and local governments
Single-part, blank tax form
For laser printers
$92.99
Per each
Medical Arts Press® FormFamily Dental Exam Form
Item #: 901-20609
Form size: 8-1/2x11"
2-hole punched on top
5-hole punched on the left side
$50.99
Per pack
($0.20/EACH)
Medical Arts Press FormFamily Periodontal Exam Form (20607)
Item #: 901-20607
Type of form: Periodontal exam form
250 per pack
Size: 8 1/2" x 11"
$56.29
1 pack
($0.23/EACH)
Save 5%
$52.99
2+ pack
($0.21/EACH)
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
Item #: 901-125557
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$123.99
Per pack
($0.05/EACH)
ComplyRight 2026 Time Off Request and Approval Form, 2-Part, 50 Forms/Pack (A0030)
Item #: 901-24202397
Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$101.99
1-2 each
Save 17%
$83.99
3+ each
Medical Arts Press® Progress Notes Patient Care Form; Green FormFamily™
Item #: 901-20381
Records detailed chronological notes of ongoing patient care for illnesses, treatments and progress
Helps you conform to NCQA & JCAHO guidelines
2-hole punched at top, 5-hole punched on left side
$47.69
1 pack
($0.19/EACH)
Save 7%
$43.99
2+ pack
($0.18/EACH)
Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074041)
Item #: 901-24617598
Patient Sign-In Label forms to sign in your patients confidentially
HIPAA Compliant
125 Sheets Per Package
$130.99
Per pack
ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)
Item #: 901-24602226
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$125.99
Per each
ComplyRight 2026 Time Off Request and Approval Form, 2-Part, 50 Forms/Pack (A0045)
Item #: 901-24202398
Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$97.69
1-4 each
Save 17%
$80.99
5+ each
Custom Florist Register Form, Classic Design, Large Format, TAX. DEL., 3 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D6723B
Multiple layout options: Choice of different layouts for tax and delivery options - Layout A: Del, Tax, Layout B: Tax, Del, Layout C: Blank, Layout D: Tax
Compatible with our registers
Additional customization options include imprinting your custom logo
Custom Florist Register Form, Classic Design, Large Format, TAX. DEL., 2 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D6722B
Multiple layout options: Choice of different layouts for tax and delivery options - Layout A: Del, Tax, Layout B: Tax, Del, Layout C: Blank, Layout D: Tax
Compatible with our registers
Additional customization options include imprinting your custom logo
ComplyRight 2025 1096 Tax Form, 1-Part, Transmittal, 10/Pack (510010)
Item #: 901-24507945
Use form 1096 to submit the totals from information returns to the Internal Revenue Service.
Transmittal Form
1 Page Equals 1 Form
$15.49
1-3 each
Save 9%
$13.99
4+ each
ComplyRight 2025 W-2 Tax Form, 4-Part, 2-Up, 50/Pack (95214E)
Item #: 901-24431085
Form W-2 and transmittal form W-3 for reporting wages and tax statements
Pre-packaged four-part form set includes copies A, B, C, D
For laser printers
$98.69
1-3 each
Save 24%
$74.99
4+ each
ComplyRight 2025 1099-MISC Tax Form, 4-Part, Copy A, C, B, 50/Pack (95914E)
Item #: 901-24431084
1099-MISC tax form for payments, such as miscellaneous income made in the course of a trade or business
Pre-packaged four-part form set contains copies A, B, C, "Copy 2", with envelopes and three 1096 transmittal forms
Compatible with laser printer
$57.99
Per each
ComplyRight 2025 W-3 Tax Form, 1-Part, Transmittal, 10/Pack (520010)
Item #: 901-24507958
W-3 summary transmittal form is used to report total annual earnings, Social Security wages, Medicare wages, and withholding for all your employees to the Social Security Administration.
Transmittal Form
1 Page Equals 1 Form
$11.59
1-3 each
Save 5%
$10.99
4+ each
ComplyRight 2025 W-3 Tax Form, 1-Part, Transmittal, 25/Pack (520025)
Item #: 901-24507961
W-3 summary transmittal form is used to report total annual earnings, Social Security wages, Medicare wages, and withholding for all your employees to the Social Security Administration.
Transmittal Form
1 Page Equals 1 Form
$37.09
Per each
ComplyRight 2025 1099-DIV Tax Form, 1-Part, 2-Up, Federal Copy A, 50/Pack (513050)
Item #: 901-24507956
File form 1099-DIV for each person: to whom you have paid dividends (including capital gain dividends and exempt-interest dividends) and other distributions on stock of $10 or more; for whom you have withheld and paid any foreign tax on dividends and
other distributions on stock; for whom you have withheld any federal income tax on dividends under the backup withholding rules; or to whom you have paid $600 or more as part of a liquidation. ...
other distributions on stock; for whom you have withheld any federal income tax on dividends under the backup withholding rules; or to whom you have paid $600 or more as part of a liquidation. ...
Federal Copy A, 2-Up
$38.19
Per each
ComplyRight 2025 1099-NEC Tax Form, 1-Part, 3-Up, Recipient Copy B, 50/Pack (NEC511150)
Item #: 901-24507937
File form 1099-NEC for each person in the course of your business to whom you have paid during the year.
Recipient Copy B, 3-Up
1 Page Equals 3 Forms
$37.09
1-7 each
Save 24%
$27.99
8+ each
ComplyRight 2025 1099 Tax Form, 2-Part, 2-Up, 50/Pack (514450)
Item #: 901-24507955
Use this universal 1099 blank tax form to file a 1099-MISC, 1099-INT, 1099-R, 1099-DIV, or 1099-B
2-up form contains stub
For laser printers
$28.69
1-5 each
Save 5%
$26.99
6+ each
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