Page 21 of hcfa cms 1500 health insurance business forms
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ComplyRight 2 Part Small Request for Time Off, Pack of 50 (A2203)
Item #: 901-2549338
Attorney-approved to ensure 100% compliance
Pack of 50 forms
Clearly outlines who is requesting and who approves paid time off
Bankers Box Liberty Corrugated File Storage Boxes, String & Button Closure, Check & Form Size, White/Blue, 12/Carton (00022)
Item #: 901-FF22
String & button, basic-duty box perfect for storing checks and forms
White/Blue corrugated storage box with standard assembly is sturdy and lightweight
Form Size, holds 6" x 9.5" files
Custom Work Orders, Job, Carbon, Small Format 2 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D2582
Custom printed business forms, with time-saving features & expert personalization
Extra-large work description area, including 13 lines for detailed write-ups
Signature line for customer authorization prevents disputes
TOPS® Application for Employment, 2-Sided, 8-1/2 x 11", 50 Sheets/Pad, 2 Pads/Box (32851)
Item #: 901-370031
2-hole punched
Application complies with all legal requirements
Includes employment history, references, education, personal information, physical record, check-offs for special questions and space for interviewer's remarks
ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211)
Item #: 901-2548999
Lets you record basic information on the outside, confidential data on the inside
Comes in distinctive blue color to distinguish medical records from other personnel file
Attorney developed and approved to ensure 100% compliance
ComplyRight™ Confidential Personnel File Folder, Pack of 25 (A221)
Item #: 901-2549002
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Outside of folder tracks employment history, termination and COBRA information and inside has ample space to file and keep important employee information
Delforms® One-Write Payroll General Expense Check Refills; 250 with Duplicates
Item #: 901-131012
Keep track of all your payroll and general expenses in one place – in one step!
No messy carbon paper
Eliminates copy errors and saves time
Custom Cash Receipt Book, 3-to-a-page, Duplicate, 225 Sets/Book
Item #: 901-TCRB1112
3-Up
Duplicate
225 sets per book
Custom Cash Receipt Book, 3-to-a-page, Triplicate, 150 Sets/Book
Item #: 901-TCRB1113
3-Up
Triplicate
150 sets per book
TOPS Employee Record Master File, 20/Pack (TOP 3280)
Item #: 901-3280Q
Employee personal file includes all you need to build a complete employee record
20 personal files per pack
Comes in manila color with blue ink
$61.99
1-3 pack
($3.10/EACH)
Save 5%
$58.99
4+ pack
($2.95/EACH)
One-Write Posting Tray
Item #: 901-100004
The best choice for basic general expense check writing
Lightweight aluminum tray provides convenient access to One-Write ledgers
Size: 11x11", 2" capacity
One-Write PostingIndex Tabs, A-Z, 11x11 (100009N)
Item #: 901-100009
The best choice for basic general expense check writing
Sturdy A-Z metal-tabbed index cards divide ledgers for easy reference
Indexes only
Medical Arts Press® Single Copy Rx Blanks, Horizontal, Alter-Proof
Item #: 901-16035
Tamper-resistant Rx pad features 5 security features
Alter-proof blue pattern background to ensure there are no erasures or modifications of information - look and regulations may vary state to state
Void Pantograph — the word "void" will appear when photocopied
Custom Service Orders, Road/Towing, Booked, Small Format 2 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D25252
Manage tasks: Small format business form simplifies paperwork at the shop or site with pre-printed checkboxes and itemization of charges
Track customer acceptance: Signature line for customer authorization prevents disputes
Stay organized: Bottom copy stays bound in towing receipt book for a permanent record; 50 sets per book
Custom Service Orders, Road/Towing, Booked, Small Format 3 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D25253
Manage tasks: Small format business form simplifies paperwork at the shop or site with pre-printed checkboxes and itemization of charges
Track customer acceptance: Signature line for customer authorization prevents disputes
Stay organized: Bottom copy stays bound in towing receipt book for a permanent record; 50 sets per book
Rediform 2-Part Carbonless Purchase Requisitions, 4.25"L x 7"W, 50 Sets/Book (1L114)
Item #: 901-421005
Material requisition book is consecutively numbered for easy organization
Business form size: 4.25"L x 7.88"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
Medical Arts Press® Duplicate Rx Books; Alter-Proof, Horizontal
Item #: 901-16024
Tamper-resistant Rx pad features 5 security features; meets October 1st 2008 Medicaid Requirements
Alter-proof blue pattern background to ensure there are no erasures or modifications of information
Void Pantograph — the word "void" will appear when photocopied
Custom Sales Slips, Classic Design, Large Format 2 Parts, 1 Color Printing, 5 2/3" x 8 1/2", 500/Pack
Item #: 901-D812
Custom printed business forms, with time-saving features & expert personalization
16 lines for writing up larger sales
Carbonless 2- or 3-part forms stay tightly aligned for clear, clean copies
ComplyRight Orthodontic Case Analysis File, 9.5" x 11.75", 25 Folders/Pack (A1048)
Item #: 901-24433069
Safely store patient records, record key patient information, case details, and benefits with this orthodontic case analysis file
Size: 9.5" x 11.75"
Beige sheet of paper with black text
Adams Time Sheets, 100/Pad, 2 Pads/Pack (ABF 9507ABF)
Item #: 901-124495
Track weekly time, including morning, afternoon, and overtime using these time sheets
Number of parts: 1
Contains 100 sheets per pad, two pads per package
Medical Arts Press® Tamper-Resistant Secure Rx/2-Part Carbonless
Item #: 901-13377
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Rediform Snap-A-Way 3-Part Carbonless Bill of Lading, 7"L x 8.5"W, 250 Sets/Book (44301)
Item #: 901-421168
Bill of lading provides accurate contractual wording for complete documentation and is punched to allow storage in a post binder
Business form size: 7"L x 8.5"W
3-Part Carbonless forms for accurate record keeping
Custom Repair Orders, Garage, Carbon, Side-Stub, Large Format, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pk
Item #: 901-D6553
27 lines for parts & accessories, plus handy odometer in/out boxes & "Save Old Parts" question box for use when scheduling maintenance
Track customer acceptance: Signature line for customer authorization prevents disputes
Consecutively numbered for easy recordkeeping
Custom Purchase Orders - Classic Small Booked,3 Parts, 1 Color Printing, 8 1/2" x 7", 250/Pack
Item #: 901-D91B3
Keep track of everything you buy! Professional Purchase Orders have preprinted columns and room to list quantities, stock numbers, descriptions and more
Signature line prevents unauthorized purchases
Create clean records: Carbonless forms stay tightly aligned for clear, clean copies