Page 27 of hcfa cms 1500 health insurance business forms
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Custom Referral for Treatment Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN132181R
Referral forms for physicians
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Bankers Box Liberty Corrugated File Storage Boxes, String & Button Closure, Check & Form Size, White/Blue, 12/Carton (00005)
Item #: 901-FF5
String & button, basic-duty box perfect for storing checks and forms
White/Blue corrugated storage box with standard assembly is sturdy and lightweight
Check Size, holds 10.75" x 23.27" files
$219.99
Per carton
($18.33/EACH)
Rediform Money Receipt Books, Carbonless, 2 Parts, 2 3/4" x 5", 50 Sheets (8L820)
Item #: 901-2675655
Size: 2 3/4" x 5"
50 forms per book
Binding: Bound
$16.99
Per each
Custom Illness / Injury Excuse Slips, 5-1/2" x 8-1/2", 100 Sheets per Pad
Item #: 901-QFN131541R
Excuse forms for work or school
5-1/2" W x 8-1/2" L
White 20# text stock; printed in black ink
Custom Snap Apart Sales Slips, 2 part, 8-1/2" x 5-2/3", 500 Sheets
Item #: 901-TGSCC6522
2-part carbonless
Sales slip measures 8-1/2"Hx5-2/3"W
500 loose sheets
Custom 4-in-1 Repair Tags w/ Claim Check & Carbons, 1 Color Printing, 3 1/8" x 9", 1000/Pack
Item #: 901-3002DQ
Detachable claim ticket
Tags are pre-strung with 8" string
Tags are pre-numbered
Custom Dental Referral Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN105751R
Referral forms for dentists
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Adams 2-Part Petty Cash Carbonless Receipts Book, 2.75" x 5", 200 Forms/Book (ABF SC1156)
Item #: 901-SC1156
Money and rent receipt book is consecutively numbered for easy organization
Business form size: 2.75"L x 5"W; detached form size: 5"L x 2.75"W
2-Part Carbonless forms for accurate record keeping
$21.99
Per each
Custom Auto Parts Sales Order - Small with Side-Stub 3 Parts, 1 Color Printing, 8 1/2" x 5 2/3",500/Pack
Item #: 901-D6573
Handy: Special columns for list and net prices
These forms come with the option to have consecutive numbering printed on them
Imprint Color: Blue
Custom Classic Small Sales Slips 3 Parts, 1 Color Printing, 4 1/4" x 7", 500/Pack
Item #: 901-D803
Consecutive numbering available
Convenient: Snapset Format
Consecutive numbering: These forms come with the option to have consecutive numbering printed on them
Custom Marine Service Orders - Classic, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D3193
Detachable stub: Forms have Detachable claim checks on tag stock
Durable: Plastic coated wire fasteners included
Consecutively numbered for easy recordkeeping
Custom Classic Small Sales Slips 2 Parts, 1 Color Printing, 4 1/4" x 7", 500/Pack
Item #: 901-D802
Consecutive numbering available
Convenient: Snapset Format
Consecutive numbering: These forms come with the option to have consecutive numbering printed on them
Global Printed Products Business Expense Accounting Journal, 8.5" x 11", Black/Blue, (GPP-0116)
Item #: 901-24629548
CLEAR PLASTIC PROTECTIVE COVER - Safeguard your financial records while maintaining easy visibility. The clear plastic cover shields your data from damage and wear, ensuring your financial information remains secure and accessible.
DAILY AND WEEKLY TOTALS GRID - Effortlessly calculate your daily and weekly expenses with dedicated grids. Stay on top of your spending patterns and gain insights into your financial habits for better decision-making.
MONTHLY TOTALS SPREAD - The monthly totals spread simplifies month-end financial assessments. Quickly review your expenses and income for each month, allowing you to identify trends and plan for the future.
$21.99
Per each
Custom Carbonless 2-Part All-Purpose Excuse Slips, 4" x 5-1/2", 50 Sets per Pad
Item #: 901-QFN131241R
Excuse forms for injuries and illnesses
4" W x 5-1/2" L
2-part, white/canary, carbonless; printed in black ink
Custom Plumbing Invoice - Invoice with Checklist, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D65403
Simplify: Combined work order and invoice covers everything: work write-ups, invoicing and cost documentation
Get the details: Lots of checkboxes and specialized fields let you write up every job quickly and accurately
Track customer acceptance: Signature line for customer authorization prevents disputes
Custom Snap Apart Sales Slips, 3 part, 7" x 4-1/4", 500 Sheets
Item #: 901-TGSCC6533
3-part carbonless
Sales slip measures 7"Hx4-1/4"W
500 loose sheets
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 Feline Pet Treatment Records, 8-1/2" x 11", 250 Sheets per Pack
Item #: 901-QFW2056301
Pet health record form
8-1/2" W x 11" L
Green 110# card stock, pre-printed in black ink
Medical Arts Press® Rx Blanks; Single Copy, Horizontal, 5-1/2x4"
Item #: 901-16010MAP
Blanks can be imprinted with doctor's name and feature standard refill instructions
Please specify State License and/or DEA numbers if desired
Numbering available
Staples Laser Forms Double Window Envelopes, Wove White, 500/Box (ST473949-CC)
Item #: 901-473949STP
Business envelopes are suitable for many mailing projects
Made from white 24 lb. paper for durability
These envelopes measure 4 1/5"H x 9"L in size, providing enough space for your mail
$46.99
Per box
($0.09/Envelope)
Bankers Box Liberty Corrugated File Storage Boxes, String & Button Closure, Check & Form Size, White/Blue, 12/Ct (00006)
Item #: 901-510583
String & button, basic-duty box perfect for storing checks and forms
White/Blue corrugated storage box with standard assembly is sturdy and lightweight
Check Size, holds 5 3/4" x 9" x 23 1/4" files
$225.99
Per carton
ComplyRight Expandable Confidential Personnel Envelo-File® (A0720)
Item #: 901-1949187
1.5" spine gives extra room for documents
Size: 11.75" x 9.5" x 1.5"
Protects legally sensitive documents
$126.99
Per each
Custom Sales Slips - Image Design, TEXT ONLY 2 Parts, 1 Color Printing, 4 1/4" x 7", 500/Pack
Item #: 901-D25902A
Professional image: Contemporary design projects a professional image
2 layout options: Available in two layouts for special wording area - Layout A is special wording only and Layout B is special wording plus a logo
Consecutive numbering: These forms come with the option to have consecutive numbering printed on them
ComplyRight™ Personnel Pocket File Folder, Pack of 25 (A1202)
Item #: 901-1949182
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Extended tab on folder helps easily locate employee from file cabinets
$94.99
1-2 each
Save 6%
$88.99
3+ each
