Page 20 of replacement forms for pegboard systems
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Custom Cash Receipt Book, 4-to-a-page, Triplicate, 200 Sets/Book
Item #: 901-TCRB1203
4-Up
Triplicate
200 sets per book
Medical Arts Press® Single Copy Rx Blanks; Vertical, 5-1/2x4"
Item #: 901-16020
Item #: 901-16020
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
Custom Progress Notes, 8-1/2" x 11", 60# White Stock, 250 Sheets per Pack
Item #: 901-QFW2058501
For use in patient charts and files
8-1/2" W x 11" L
White 60# text stock, pre-printed in black ink
Rediform® Carbonless Delivery Receipt Books, 4-1/4" x 6-3/8", 2 Part
Item #: 901-508625
Item #: 901-508625
$13.99
Per each
Custom Certificate of Professional Care Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131111R
For certification of care
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Adams 2-Part Carbonless Sales Orders, 7.19"L x 3.34"W, 50 Sets/Book (DC3705)
Item #: 901-DC3705
Item #: 901-DC3705
Sales and order books are ideal for keeping proper records of orders and sales
Size: 7.19"L x 3.34"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$18.99
Per each
ComplyRight ADA Self-Seal Envelope (2003ES)
Item #: 901-728692E
Item #: 901-728692E
Self-Seal Envelope you can use it for 2002, 2004, & 2006 Versions
Dimensions: 9.5" W x 4.125" H
Pack size 500
TOPS Credit Card Sales 3-Part Carbonless Receipts, 3.25"L x 7.88"W, 100 Sets/Book, 5/Carton (38538CT)
Item #: 901-810999CT
Item #: 901-810999CT
Triplicate Credit Card Sales Slips are made with carbonless paper to protect your customers; no carbon tissues containing credit card information to worry about
Size: 3.25"L x 7.88"W
Features a carbonless 3-part format and comes in white
$119.99
1-2 carton
Save 8%
$109.99
3+ carton
ComplyRight Federal (Bilingual), State and Public Sector (English) Labor Law Poster Set, Texas (EFEDSTCRPSECBTX)
Item #: 901-1949202TFP
Item #: 901-1949202TFP
FEDERAL COMPLIANCE ALERT: June 27, 2023, the Pregnant Workers Fairness Act (PWFA) requires covered employers to post a notice describing the law’s protections (revised “Know Your Rights” poster). Also, May 4, 2023, the Department of Labor released a
mandatory update to the FLSA/Federal Minimum Wage poster, adding details regarding break times for nursing employees. All ComplyRight posters and services that cover federal postings now include the updated versions of these mandatory postings ...
mandatory update to the FLSA/Federal Minimum Wage poster, adding details regarding break times for nursing employees. All ComplyRight posters and services that cover federal postings now include the updated versions of these mandatory postings ...
Developed to meet the additional federal and state posting needs of public sector employers
Adams 2-Part Carbonless Guest Checks, 4.25"L x 7.25"W, 250 Sets/Book (947SWC)
Item #: 901-947SWC
Item #: 901-947SWC
Guest check form is used to record the receipt of petty cash, rent, or other payments
Buziness form size: 4.25"L x 7.24"W; detached form size: 6.75"L x 4.25"W
2-Part Carbonless forms for accurate record keeping
$31.99
Per pack
Staples Laser Forms Double Window Envelopes, Wove White, 500/Box (ST473949-CC)
Item #: 901-473949STP
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)
Custom Carbonless Numbered White Receipt Books, 4-3/4" x 2-3/4", 500 Receipts per Book
Item #: 901-QFW1202001
Self-duplicating; everything is printed on original and duplicate
Book size is 11-1/2" W x 8-1/2" L; detached receipt size is 4-3/4" W x 2-3/4" L
White self-duplicating carbonless stock; pre-printed in black ink
TOPS™ Money/Rent Receipt Book, 3-Part, 50 Sheets/Book (TC2701-3)
Item #: 901-448242
Item #: 901-448242
Money/Rent Receipt book to offer receipts for rent and other monetary exchanges at
Dimensions: 1.5"H x 2.75"W x 7.19"L, 6.69" x 2.75" (detached form), 7.19" x 2.75" (sheet)
Color: White (primary page), pink (triplicate page), canary (duplicate page), blue (ink)
$27.99
Per each
Saunders Snapak Recycled Aluminum Form Holder, Letter Size, Silver (10517)
Item #: 901-137109
Item #: 901-137109
Form holder provides functionality and solid support for documents
Letter-size clipboard - keep documents in place
Made of high-quality gray/silver aluminum for maximum durability
$52.99
Per each
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #: 901-398026
Item #: 901-398026
Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
HIPAA compliant
Size: 8 1/2" x 11"
Custom 1-Sided Pegboard Account Cards, 5-1/2" x 8-1/2", 110# Index Stock, 500 Cards per Pack
Item #: 901-QFN101351R
For use with a pegboard system
5-1/2" W x 8-1/2" L
White 80# cover stock, printed in black ink
Custom Progress Notes, 8-1/2" x 11", 24# White Stock, 250 Sheets per Pack
Item #: 901-QFW2175701
For use in patient charts and files
8-1/2" W x 11" L
White 24# ledger stock, pre-printed in black ink
Custom Carbonless Numbered Blue Receipt Books, 4-3/4" x 2-3/4", 500 Receipts per Book
Item #: 901-QFW1202201
Self-duplicating; everything is printed on original and duplicate
Book size is 11-1/2" W x 8-1/2" L; detached receipt size is 4-3/4" W x 2-3/4" L
Blue self-duplicating carbonless stock; pre-printed in black and blue ink
ComplyRight Confidential Personnel Envelo-File, Legal Size, 25/Pack (A0731)
Item #: 901-2549007
Item #: 901-2549007
Protects legally sensitive documents
Outside grid lets you record general employee information and benefits data directly on the folder
Attorney developed and approved to ensure 100% compliance
Custom Dental Extraction Instruction Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131161R
Use to convey instructions to patients
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Medical Arts Press® Contact Lens Rx Blanks; 2-Part
Item #: 901-15586
Item #: 901-15586
Conforms to all new requirements of federal Fairness to Contact Lens Consumers Act (FCLCA)
Option to include customer warning regarding need for periodic eye exams (required in some states)
Black print on white stock
TOPS® Bill of Lading Unit Set, Ruled, 4-Part Carbonless, 11-7/16" x 8-1/2", 50/Pack (3847)
Item #: 901-903257
Item #: 901-903257
Originals are printed in Light Blue, duplicates in Blue
White carbonless paper
Hazardous material information areas are printed in Red
$79.99
1-4 box
Save 5%
$75.99
5+ box
Custom Treatment Notes, 8-1/2" x 11", 250 Sheets per Pack
Item #: 901-QFN105601R
For use in patient charts
8-1/2" W x 11" L
White 20# text stock; printed in black ink
Rediform 2-Part Carbonless Purchase Requisitions, 8.5"L x 11"W, 50 Sets/Book (RED1L146)
Item #: 901-2675658
Item #: 901-2675658
Purchase order book.
17 lines
Brand: Rediform
$36.99
Per each
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