Page 22 of replacement superbill forms
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Medical Arts Press Invoices, 8-1/2" x 11", 500 Sets/Book, 500/Pack (33176D)
Item #: 901-33176D
Credit card alert helps speed payment - VISA and MasterCard only
Includes patient update
Easy-tear perforation is 3-11/16" from top for removal of white payment stub
$50.99
1-3 pack
($0.10/EACH)
Save 6%
$47.99
4+ pack
($0.10/EACH)
Purchase Order Book, 2 Parts, Carbonless, 5 1/2" x 7 7/8"
Item #: 901-2675659
In duplicate and triplicate formats
White original, canary duplicate, pink triplicate
50 sets per book
$23.99
Per each
Medical Arts Press Treatment Notes, Tooth Diagram, Non-Imprinted, No Punch
Item #: 901-21150NP
Set per pack (uom): 250 per pack
Size: 8 1/2" x 11"
Dental exam chart format
$51.99
Per pack
($0.21/EACH)
Medical Arts Press Progress Notes; Standard 2-Hole Punch (20585RL)
Item #: 901-20585NP
60 lb. stock
For custom punch order item # 20585
250 per package
$90.29
1-3 pack
($0.36/EACH)
Save 8%
$82.99
4+ pack
($0.33/EACH)
Custom Appointment Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131551R
Excuse forms for appointments
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Custom Release to School / Work Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131071R
Return to work or school forms
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Adams Carbon Rental Applications, 8.5" x 11", (LF255)
Item #: 901-571368
The easy-to-use, month-to-month rental agreement form allows you to lease residential property on a monthly basis, specifying all terms and conditions from security deposits to late charges
Form size: 11"L x 8.5"W
Form duplicate: carbon; comes in white
$12.99
Per each
ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)
Item #: 901-1949181
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Expanded folder has 1.5” spine which holds more than 100 employee documents
$165.99
1-2 each
Save 19%
$134.99
3+ each
ComplyRight™ HIPAA Notice of Privacy Practices Poster (A2123)
Item #: 901-728245
Communicates mandatory HIPAA rules to patients
Laminated
Informs patients of their rights and responsibilities under HIPAA regulations
$34.99
Per each
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
ComplyRight 1-Part Personnel Folder, 25/Pack (A223)
Item #: 901-1949180
Personnel folder keeps quick information on the outside and confidential records on the inside
One-part personnel folder
Contains 25 folders per package
$96.99
Per each
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
$74.99
Per each
Custom Dental Appointment Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131421R
Excuse forms for dental appointments
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Custom Appointment Excuse Slips, 5-1/2" x 8-1/2", 100 Sheets per Pad
Item #: 901-QFN131531R
Excuse forms for work or school
5-1/2" W x 8-1/2" L
White 20# text stock; printed in black ink
ComplyRight Concealed Cover Confidential Employee Record Folder, Pack of 25 (A0653)
Item #: 901-2549003
Two spacious pockets provide additional storage room for documents
Specific information can be recorded right on the pockets
Attorney developed and approved to ensure 100% compliance
$124.99
Per each
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
$20.99
1-9 each
Save 19%
$16.99
10+ each
TOPS™ Guest Check Pad, 1-Part, 100 Sheets/Pad (2100-12)
Item #: 901-196279
Guest Check pad is great for a home, office or business purpose
Dimensions: 3.35"H x 4.13"W x 5.44"L, 4.94" x 3.35" (detached form), 5.44" x 3.34" (sheet)
Color: White (primary page), blue (ink)
$16.99
Per pack
Adams 2-Part Carbonless Sales Orders, 7.19"L x 3.34"W, 50 Sets/Book (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
$13.99
Per each
Custom All-Purpose Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131521R
Excuse forms for work or school
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Delforms® One-Write General Expense Journal Sheets; General Expense, 1-Part
Item #: 901-111021
No messy carbon paper
Eliminates copy errors and saves time
Sheet size; 25-3/8" x 11"
$35.99
1 pack
($2.40/EACH)
Save 22%
$27.99
4+ pack
($1.87/EACH)
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
$80.99
Per pack
Adams 2-Part Carbonless Invoices, 8-1/2" x 7-7/16", 50 Sets/Book (NC2872-50)
Item #: 901-442798
2-part carbonless with a white, canary paper sequence
Ruled format
Space at top for company stamp
$34.99
Per pack
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
