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Custom 1 & 2 Color Letterhead, 8.5" x 11", 25% Cotton Writing 24# Stock, 2 Standard Inks, Raised Print
Item #: 901-QCLH00015
A strong 24 lb. text weight writing stock with a cockle finish made from 25% cotton
A standard letter size of 8.5" x 11"
250 letterhead per pack
Custom 4-1/4"x6-1/2" Double-Duty Statement Std Remit Env with Security Tint, 24# White Wove, 1 Std and 1 Custom Inks, 250/Pack
Item #: 901-QCENV00823
4-1/4" x 6-1/2" Envelopes, Gum Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
250 Envelopes Per Pack
Custom 1 & 2 Color Letterhead, 8.5" x 11", 25% Cotton Writing 24# Stock, 2 Custom Inks, Raised Print
Item #: 901-QCLH00018
A strong 24 lb. text weight writing stock with a cockle finish made from 25% cotton
A standard letter size of 8.5" x 11"
250 letterhead per pack
Custom 1 & 2 Color Letterhead, 8.5" x 5.5", 25% Cotton Writing 24# Stock, 2 Standard Inks, Raised Print
Item #: 901-QCLH00025
A strong 24 lb. text weight writing stock with a cockle finish made from 25% cotton
A half sheet size of 5.5" x 8.5"
250 letterhead per pack
Custom 1 & 2 Color Letterhead, 8.5" x 5.5", 25% Cotton Writing 24# Stock, 2 Custom Inks, Raised Print
Item #: 901-QCLH00028
A strong 24 lb. text weight writing stock with a cockle finish made from 25% cotton
A half sheet size of 5.5" x 8.5"
250 letterhead per pack
Custom #10 Barcode Peel and Seal Envelopes, 4 1/4" x 9 1/2", 24# White 25% Cotton Bond, 1 Standard Ink, 250 / Pack
Item #: 901-QCENV00907
4-1/8" x 9-1/2" (#10 Envelopes), Peel and Seal
24# White 25% Cotton Bond Stock with Custom Barcode, Flat Ink
250 Envelopes Per Pack
Custom 1 & 2 Color Letterhead, 8.5" x 5.5", 25% Cotton Writing 24# Stock, 1 Standard and 1 Custom Inks, Flat Print
Item #: 901-QCLH00031
A strong 24 lb. text weight writing stock with a cockle finish made from 25% cotton
A half sheet size of 5.5" x 8.5"
250 letterhead per pack
Medical Arts Press® Chiropractic Registration and History Form, 250 Forms/Pack (21701)
Item #: 901-21701
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
$74.79
Per pack
($0.30/EACH)
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
Medical Arts Press® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
Item #: 901-20596
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)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
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
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
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
Medical Arts Press Dental Registration Forms, 250/Pack (20558)
Item #: 901-20558NP
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)
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
Item #: 901-125557
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
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 901-CMS12LC250
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)
Medical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Item #: 901-21786
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)
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
Item #: 901-2408453
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)
Medical Arts Press® Chiropractic Registration and History Form without Updates, Sky Blue, 250 Forms/Pack (20572)
Item #: 901-20572
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)
Medical Arts Press® Dental Registration and History Form; Purple and Teal Design
Item #: 901-20579
Item #: 901-20579
Medical Arts Press Registration Form; Smile Team
Item #: 901-21784
Item #: 901-21784
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Friendly "happy teeth" design welcomes patients
Printed in 2-color on two sides on 24-lb. white bond paper
$80.29
1 pack
($0.32/EACH)
Save 7%
$74.79
2+ pack
($0.30/EACH)
Sof-Form® Non-sterile Conforming Gauze Bandages; 75" L x 2" W, 96/Pack
Item #: 901-113612MED
Item #: 901-113612MED
Rayon/Polyester Material
Non-sterile
Latex-free
TOPS™ Carbonless General Purpose Form, 2-Part, 100 Sheets/Pack (NC2581)
Item #: 901-301770
Item #: 901-301770
Two-part all-purpose forms for sales, orders, purchase orders, and credit memos
Dimensions: 8.5" x 5.67" (detached form), 8.5" x 5.12" (full sheet)
White original top copy for customers, canary duplicate copy for your records with a blue ink
Adams® Job Invoice Form, Ruled, 8" x 11", 2-Part, White, 100 Sheets/Pack (NC2817)
Item #: 901-468769
Item #: 901-468769
Carbonless job invoice sets for service industries
Dimensions: 8.5" x 11.44" x 1.1"
White original to copy and white duplicate with blue text
$17.19
Per each
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
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