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Page 4 of adams receiving record materials stock requisition forms

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Adams Time Cards, 200/Pack (ABF 9675-200)Adams Time Cards, 200/Pack (ABF 9675-200)
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Adams Time Cards, 200/Pack (ABF 9675-200)
Item #: 901-319681
(77)
Item #: 901-319681
Use time cards to track employee arrival time, breaks, lunches, overtime, and departure times
Compatible with: Acroprint 125, 150, 175, ES700, ES900, ESP180, Amano PIX, TCX series, Lathem 900E, 1200 series, 1500E, 2000 series, 4000 series, 5000EP
Dimensions: 3.38"W x 9"L
$16.79
1-3 pack
Save 5%
$15.99
4+ pack
Add to cart
Earn 16 points
Free 1-2 day delivery w/ $25+
Adams Carbonless Rental Applications, 8.5 x 11, 4 Sets/Book (LF310)Adams Carbonless Rental Applications, 8.5 x 11, 4 Sets/Book (LF310)
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Adams Carbonless Rental Applications, 8.5" x 11", 4 Sets/Book (LF310)
Item #: 901-571323
(318)
Item #: 901-571323
Specify the rights and obligations of both landlord and tenant
Includes four sets of forms, instructions and Lead Paint Disclosure CD-ROM
Use to lease residential rental property to a tenant and outline the terms and conditions for payment
$15.79
Per each
Add to cart
Earn 15 points
Free 1-2 day delivery w/ $25+
Adams Single Sided Time Cards, 200/Pack (ABF 9656-200)Adams Single Sided Time Cards, 200/Pack (ABF 9656-200)
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Adams Single Sided Time Cards, 200/Pack (ABF 9656-200)
Item #: 901-319707
(85)
Item #: 901-319707
Use time cards to track employee arrival time, breaks, lunches, overtime, and departure times
Compatible with: Acroprint 125, 150, 175, ES700, ES900, ESP180, Amano PIX, TCX series, Lathem 900E, 1200 series, 1500E, 2000 series, 4000 series, 5000EP
Dimensions: 3.38"W x 9"L
$16.79
1-3 pack
Save 5%
$15.99
4+ pack
Add to cart
Earn 16 points
Free 1-2 day delivery w/ $25+
Medical Arts Press® Chiropractic Registration and History Form, 250 Forms/Pack (21701)Medical Arts Press® Chiropractic Registration and History Form, 250 Forms/Pack (21701)
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Medical Arts Press® Chiropractic Registration and History Form, 250 Forms/Pack (21701)
Item #: 901-21701
(2)
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
$74.79
Per pack
($0.30/EACH)
Add to cart
Earn 74 points
Free delivery
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)
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ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
(85)
Item #: 901-CMS12LC1
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
$55.99
Per carton
($0.06/EACH)
Add to cart
Earn 55 points
Free 1-2 day delivery
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2 x 11, 250/Pack (50135RV)
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TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
Item #: 901-2408453
(16)
Item #: 901-2408453
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits
Top sensor bar for microfiche duplication, as required in some states
OCR red ink for scanning
$26.09
Per pack
($0.10/EACH)
Add to cart
Earn 26 points
Free delivery
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)
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ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
(34)
Item #: 901-CMS12LC500
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
$50.99
Per pack
($0.10/EACH)
Add to cart
Earn 50 points
Free delivery
Medical Arts Press Dental Registration Forms, 250/Pack (20558)Medical Arts Press Dental Registration Forms, 250/Pack (20558)
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Medical Arts Press Dental Registration Forms, 250/Pack (20558)
Item #: 901-20558NP
(3)
Item #: 901-20558NP
Type of form: Dental registration form
250 per pack
Size: 8 1/2" x 11"
$60.99
Per pack
($0.24/EACH)
Add to cart
Earn 60 points
Free delivery
Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
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Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
Item #: 901-20596
(4)
Item #: 901-20596
HIPAA compliant insurance authorization
Help ensure reimbursement and improve risk management
Collects printed name and relationship to patient
$57.99
Per pack
($0.23/EACH)
Add to cart
Earn 57 points
Free delivery
Medical Arts Press Registration Forms without Updates Section ; Brush SilhouetteMedical Arts Press Registration Forms without Updates Section ; Brush Silhouette
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Medical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Item #: 901-21786
(1)
Item #: 901-21786
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Silhouetted toothbrush design welcomes patients
Printed in 1-color on two sides on 24-lb. white bond paper
$56.99
Per pack
($0.23/EACH)
Add to cart
Earn 56 points
Free delivery
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
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ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 901-CMS12LC250
(51)
Item #: 901-CMS12LC250
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
$47.29
Per box
($0.19/EACH)
Add to cart
Earn 47 points
Free delivery
Medical Arts Press® Dental Treatment Consent Form; 1-SidedMedical Arts Press® Dental Treatment Consent Form; 1-Sided
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Medical Arts Press® Dental Treatment Consent Form; 1-Sided
Item #: 901-20606
Item #: 901-20606
Provides your patient complete information about their treatment and its risks
Obtains written consent for your records
Just check off applicable conditions; patient reads explanation, initials and signs
$20.99
1 pack
($0.08/EACH)
Save 5%
$19.99
2+ pack
($0.08/EACH)
Add to cart
Earn 20 points
Free delivery w/ $25+
Custom Dental Registration Forms, 8-1/2 x 11, 250 Sheets per PackCustom Dental Registration Forms, 8-1/2 x 11, 250 Sheets per Pack
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Custom Dental Registration Forms, 8-1/2" x 11", 250 Sheets per Pack
Item #: 901-QFW2055801
Item #: 901-QFW2055801
Pricing details
Includes complete personal and insurance information, and assignment and release for easy account set up
8-1/2" W x 11" L
White 24# bond stock, pre-printed in black and blue ink
$29.99
1 pack
($0.12/EACH)
Save 26%
$22.29
20+ pack
($0.09/EACH)
Customize
Earn 29 points
Free delivery
Cosco Patient Bilingual Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074042)Cosco Patient Bilingual Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074042)
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Cosco Patient Bilingual Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074042)
Item #: 901-24617599
(4)
Item #: 901-24617599
Patient Bilingual Sign-In Label forms to sign in your patients confidentially
HIPAA Compliant
125 Sheets Per Package
$75.99
Per pack
Add to cart
Earn 75 points
Free delivery
Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074041)Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074041)
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Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074041)
Item #: 901-24617598
(2)
Item #: 901-24617598
Patient Sign-In Label forms to sign in your patients confidentially
HIPAA Compliant
125 Sheets Per Package
$74.99
Per pack
Add to cart
Earn 74 points
Free delivery
Medical Arts Press® Chiropractic Registration and History Form without Updates, Sky Blue, 250 Forms/Pack (20572)Medical Arts Press® Chiropractic Registration and History Form without Updates, Sky Blue, 250 Forms/Pack (20572)
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Medical Arts Press® Chiropractic Registration and History Form without Updates, Sky Blue, 250 Forms/Pack (20572)
Item #: 901-20572
(6)
Item #: 901-20572
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
$76.29
1 pack
($0.31/EACH)
Save 6%
$71.99
2+ pack
($0.29/EACH)
Add to cart
Earn 76 points
Free delivery
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
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ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
Item #: 901-125557
(58)
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)
Add to cart
Earn 123 points
Free delivery
Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074039)Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074039)
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Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074039)
Item #: 901-24617595
(2)
Item #: 901-24617595
Patient Sign-In Label forms to sign in your patients confidentially
HIPAA Compliant
125 Sheets Per Package
$75.99
1-9 pack
Save 9%
$69.39
10+ pack
Add to cart
Earn 75 points
Free delivery
Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074043)Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074043)
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Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074043)
Item #: 901-24617597
(2)
Item #: 901-24617597
Patient Sign-In Label forms to sign in your patients confidentially
HIPAA Compliant
125 Sheets Per Package
$74.99
1-5 pack
Save 10%
$67.39
6+ pack
Add to cart
Earn 74 points
Free delivery
Tabbies 3-Part Patient Sign-in Label Forms, 125/Pack (14532)
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Tabbies 3-Part Patient Sign-in Label Forms, 125/Pack (14532)
Item #: 901-2678548
(4)
Item #: 901-2678548
Patient sign-in label forms to sign in your patients confidentially
Form consists of three parts: a label sheet, a carbon sheet, and a log behind it
125 sheets per package
$71.09
Per pack
($0.57/EACH)
Add to cart
Earn 71 points
Free delivery
ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
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ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Item #: 901-24614845
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
$46.99
Per each
Add to cart
Earn 46 points
Free delivery
Medical Arts Press® Dental Registration and History Form; Purple and Teal DesignMedical Arts Press® Dental Registration and History Form; Purple and Teal Design
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Medical Arts Press® Dental Registration and History Form; Purple and Teal Design
Item #: 901-20579
Item #: 901-20579
$18.19
Per pack
($0.07/EACH)
Add to cart
Earn 18 points
Free delivery w/ $25+
Custom Laser Top Checks, Unlined, 1 Ply, 1 Color Printing, Standard Check Color, 8-1/2 x 11, 500/PkCustom Laser Top Checks, Unlined, 1 Ply, 1 Color Printing, Standard Check Color, 8-1/2 x 11, 500/Pk
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Custom Laser Top Checks, Unlined, 1 Ply, 1 Color Printing, Standard Check Color, 8-1/2" x 11", 500/Pk
Item #: 901-DLT1041S1C
(9)
Item #: 901-DLT1041S1C
Pricing details
Built-in check security trusted by 7,000 financial institutions nationwide, with features such as chemically sensitive paper, microprint border, erasure protection, security screen & warning box
2 blank tear-off vouchers have plenty of room to document transactions for you & your employee or vendor
Sheet format fits all standard laser & inkjet printers
$180.99
1-3 pack
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Adams Employees Copies Cut Sheet 2025 W-2 Tax Form, 4-Part, Copy B & C, 100/Pack (LW24UPB100)
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Adams Employee's Copies Cut Sheet 2025 W-2 Tax Form, 4-Part, Copy B & C, 100/Pack (LW24UPB100)
Item #: 901-5209
(32)
Item #: 901-5209
2025 Blank W-2 Forms have Copy B & C instructions printed on the back
2025 W-2 forms must be mailed or eFiled to the SSA and furnished to your employees by February 2, 2026; IRS eFile regulations require e-Filing for 10 or more returns of certain forms; Use Adams Tax Forms Helper to eFile to the IRS/SSA
Blank W-2 forms include Copy B & C instructions on the back
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