Page 5 of hipaa patient record of disclosures
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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
Medical Arts Press Eye Care Registration Form (20571)
Item #: 901-20571
Type of form: Registration form
250 per pack
Size: 8 1/2" x 11"
Wilson Jones Ledger Paper, 24 Columns, 11" x 14", Green, 100 Sheets (WLJG3024)
Item #: 901-2660911
11" x 14"
100 sheets
36 lines per page, 24 columns
Original E-Z Grader, Blue, Grade K-12 (EZ-5703-3)
Item #: 901-24496210
Fast grading experience for up to 95 problems
Grade K-12
8-1/2" x 4-3/4" x 1/8"
Rediform Emerald Series Record Book, 7.31"W x 11.88"H, Green, 250 Sheets/Book (56151)
Item #: 901-56151Q
Record and protect information in this canvas hardcover account book
500 numbered pages, record blue ruling with margin, 40 lines per page
Overall dimensions: 7.31"W x 11.88"H
Rediform Money Receipts Collection Forms, Carbonless, 3 Parts, 2 3/4" x 7" (8L802)
Item #: 901-609032
Size: 2 3/4" x 7"
50 forms per book
1 form per page
Blueline AccountPro Record Book, 7.69" x 10.25", Black, 150 Sheets/Book (A7963C.01)
Item #: 901-A7963CBK
Book is perfect for accurate record and account keeping
Black hard cover with twin-wire binding
Includes 300 numbered pages with green and brown ruling
Boorum & Pease 38 Series Record Book, 7.63" x 9.63", Black/Red, 150 Sheets/Book (38-300-R)
Item #: 901-38300R
Book for records and daily schedules
Elegant black covers with red spine and corners
Includes 300 numbered pages
Dome Short-Cut Payroll Book, 8 Columns, 11.25" x 8.75", Navy (650)
Item #: 901-137240
For businesses with 1-50 employees
Double-page spread
Holds records for one year
Veterinary Examination Labels, Physical Exam Checklist, White, 1.75 x 3.25 inch, 500 Labels
Item #: 901-39206
Save Writing & Record Keeping Time with This White Physical Exam Checklist Label
Pressure-Sensitive
Size: 3.25 X 1.75 Inch
Staples Dollar and Cent Accounting Journal, 144 Pages, Brown (182022ABF)
Item #: 901-182022
This accounting journal is designed to document your cash flow and finances
Comes with brown cover and includes pages of white paper with blue and red lines
Compact book provides 144 pages with single-entry ledger rulings
Adams 2-Part Carbonless Purchase Requisitions, 8.44"L x 5.56"W, 50 Sets/Book (DC5831)
Item #: 901-DC5831
Keep a bound copy for a permanent record using this purchase requisitions
Business form size: 8.44"L x 5.56"W; detached form size: 5.56"L x 7.94"W
2-Part Carbonless forms for accurate record keeping
Rediform Emerald Series Record Book, 7.25" x 12.25", Green, 75 Sheets/Book (RED56111)
Item #: 901-912043
These account books feature green book cloth covers and white paper acid-free, archival safe paper
Pages are numbered for easy reference and made of acid-free, archival safe paper
Features green book cloth covers and white paper acid-free, archival safe paper
Staples 3" x 5" Index Cards, Lined, White, 500/Pack (TR51009)
Item #: 901-233601
Take notes, record recipes, or keep track of large projects with index cards
3" x 5" narrow-ruled cards
White index cards
Verbatim 94554 52x CD-R, 700MB Capacity, Gray, 100/Pack
Item #: 901-479609
CD-R helps you safely burn your personal and work files for convenient use anytime
Comes in gray color with 52x write speed for quick data transfer
CD-R allows users to record up to 700MB of data
2000 Plus Printer Line Rectangle Dater Stamp, Black Ink, 1 1/16" x 5/32" (011090)
Item #: 901-507842
Versatile 12-in-1 Stamp: This self-inking stamp offers a 1-7/8" x 3/16" impression area and features 12 pre-set phrases, including Approved, Urgent, Emailed, Cancelled, Charged, Checked, Delivered, Credit, Faxed, Paid, Received, or Shipped.
Efficient Date Recording: Four-band date includes months, days, and a 5-year band, ensuring accurate and up-to-date record keeping.
Sharp and Clear Impressions: Enjoy professional and everyday use with sharp and clear impressions using the included black ink.
Adams 2-Part Carbonless Sales Orders, 8.44"L x 5.56"W, 50 Sets/Book (DC5805)
Item #: 901-196113
Sales and order books are ideal for keeping proper records of orders and sales
Business form size: 5.56"W x 8.44"L; detached: 5.56"W x 7.94"L
2-Part White/Canary Carbonless forms for accurate record keeping
Logitech C920S Pro 1080p HD Webcam, Black (960-001257)
Item #: 901-24383955
Make a strong impression in your video conference calls with a diagonal, fixed 78° field of view to perfectly frame you and your space—plus full HD at 1080p/30fps or 720p/30fps.
Two microphones capture more realistic sound from a broader range of angles—so your voice comes through sounding natural and clear in conference calls.
Easily create, record, and customize settings with our Capture app. A suite of features lets you fully edit and customize your stream.
Adams Phone Message Pad, 5.5" x 11", White, 100 Sheets/Pad, 2 Pads/Pack (SC1154-2D)
Item #: 901-SC11542D
Sheet Dimensions: 5.5" x 8.5"
100 pages with 400 total forms per book to record ample messages
Package contains 2 books per pack
$19.89
1-2 pack
($9.95/EACH)
Save 5%
$18.99
3+ pack
($9.50/EACH)
Staples 3" x 5" Index Cards, Lined, Assorted Colors, 300/Pack (TR50998)
Item #: 901-916330STP
Take notes, record recipes, or keep track of large projects with index cards
3" x 5" narrow-ruled cards
Index cards come in assorted neon colors
Staples 3" x 5" Index Cards, Narrow Ruled, White, 100/Pack (TR50993)
Item #: 901-296608
Take notes, record recipes, or keep track of large projects with index cards
3" x 5" narrow-ruled cards
White index cards
Verbatim Life Series 97175 16X DVD+R 4.7GB, 100 Pack Spindle
Item #: 901-49087
DVD+R provides ample storage space for your data
Comes in silver color with 16x write speed for quick data transfer
DVD+R allows users to record up to 4.7GB of data
Staples 3" x 5" Index Cards, Blank, White, 500/Pack (TR51010)
Item #: 901-233593
Take notes, record recipes, or keep track of large projects with index cards
3" x 5" blank cards
White index cards
