Page 26 of replacement superbill forms
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Custom Progress Notes, 8-1/2" x 11", 24# White Stock, 250 Sheets per Pack
Item #: 901-QFW2054101
For use in patient charts and files
8-1/2" W x 11" L
White 24# ledger stock, pre-printed in black ink
TOPS® Bill of Lading Unit Set, Ruled, 4-Part Carbonless, 11-7/16" x 8-1/2", 50/Pack (3847)
Item #: 901-903257
Originals are printed in Light Blue, duplicates in Blue
White carbonless paper
Hazardous material information areas are printed in Red
$77.49
1-4 box
Save 5%
$72.99
5+ box
TOPS™ Gift Certificate Book, 1-Part, 25/Book (GFTBK1)
Item #: 901-448269
Gift Certificate book to personalize your gift
Dimensions: 0.13"H x 3.25"W x 11"L, 7.81" x 3.25" (detached form), 11" x 3.25" (sheet)
Color: Cream (primary page), maroon (ink)
$9.49
Per 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)
$15.99
Per pack
Custom Carbonless Side-Stub Job Work Order, Large Format, 2 Parts, 1 Color Printing, 8 1/2" x 5 1/2", 500/Pack
Item #: 901-D2132
Preprinted areas for material costs, descriptions, labor, signature & dates
Last part is durable tag stock preprinted with a material & labor record for future reference
Consecutive numbering: These forms come with the option to have consecutive numbering printed on them
Posting File, For Forms Up To 7-1/2x9-1/2"
Item #: 901-31134
Large tray features 3 tilt plates for support
Sturdy metal construction with gray baked enamel finish
Holds forms up to 7-1/2Wx9-1/2Hx6"D, up to a 6" stack of forms
$212.99
1-2 each
Save 8%
$193.99
3+ each
Custom Continuation Notes, 8-1/2" x 11", 500 Sheets per Pack
Item #: 901-QFW2013X01
For use in patient charts and files
8-1/2" W x 11" L
60# text stock, pre-printed in black ink; available in pink, yellow, green, and blue for setting up a color-coding system
Custom Cash Receipt Book, 3-to-a-page, Duplicate, 225 Sets/Book
Item #: 901-TCRB1182
3-Up
Dupllicate
225 sets per book
Boorum & Pease Log Record Book, 8.13"W x 10.38"H, Black, 75 Sheets/Book (G21-150-R)
Item #: 901-508644
Black durable cover with gold foil stamped titles
Includes 150 numbered pages
Overall dimensions: 8.13"W x 10.38"H
$130.69
Per each
Quill Brand® 9.5" x 11" Continuous Form Paper, 18 lbs., 92 Brightness 2550 Sheets/Carton (710608)
Item #: 901-710608
Continuous form bond paper
Paper weight: 18 lbs.
Size: 9-1/2x11" (8-1/2" width with carrier strips removed)
$94.59
Per carton
Saunders Snapak Recycled Aluminum Form Holder, Letter Size, Silver (10517)
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
$50.99
Per each
Dome Simple Weekly Bookkeeping Record, 8.75" x 11.25", Black (600)
Item #: 901-600
Size: 8.75"x11.25"
Printed on recycled paper.
Makes bookkeeping a snap
$24.39
Per each
ComplyRight™ Application for Employment
Item #: 901-AR0374
Front has applicants personal information
Back covers previous employment and plain-language disclosures
Each form includes a free tip sheet with do's and don'ts for proper usage
$67.89
1-2 pack
($1.36/EACH)
Save 16%
$56.99
3+ pack
($1.14/EACH)
Quill Brand® 9.5" x 11" Continuous Form Paper, 20 lbs., 92 Brightness 2550 Sheets/Carton (710657)
Item #: 901-710657
Continuous form bond paper
Paper weight: 20 lbs.
Size: 9-1/2x11" (8-1/2" width with carrier strips removed)
$122.39
Per carton
Custom 1-Sided Pegboard Account Cards, 5-1/2" x 8-1/2", 26# Coated Back Ledger Sheet, 500 Cards per Pack
Item #: 901-QFN101XX1R
For use with a pegboard system
5-1/2" W x 8-1/2" L
Comes in white colored 26# coated back ledger stock, printed in black ink
Rediform Texhide Record Book, 7 7/8" x 10", Black, 80 Sheets/Book (56211)
Item #: 901-56211
Book for records and daily schedules
Black leather-like cover with burgundy spine and corners
Includes 160 numbered pages with green and brown ruling
$54.19
Per each
Staples Record Book, 7.25"W x 11.75"H, Blue Marble, 300 Sheets/Book (886673)
Item #: 901-886673STP
Blue marble hardcover with silver foil stamped title
Includes 300 numbered pages, features blue and red lines
Overall dimensions: 7.25"W x 11.75"H
$51.99
Per each
Custom 2-Sided Progress Notes, 8-1/2" x 11", 24# White Stock, 250 Sheets per Pack
Item #: 901-QFN117571R
For use in patient charts
8-1/2" W x 11" L
White 20# text stock; printed in black ink
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
Staples Ledger Binder, 200 Pages, Blue Marble (26520)
Item #: 901-296509
Ledger binder is an excellent choice for storing your important documents
Blue marbled cover and white bond paper
Includes 200 pages printed on front and back with green lines
$44.59
Per each
Custom Carbonless Veterinary Charge Slips, 5-1/2" x 8-1/2", 100 Sheets per Pad
Item #: 901-QFW1302501
For use by veterinary facilities to provide itemized receipts and bills to their customers
5-1/2" W x 8-1/2" L
1-part, white, carbonless; pre-printed in black ink
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
Custom X-Ray I.D. Cards, 5" x 3", 250 Cards per Pack
Item #: 901-QFN101XID1R
For use on X-Rays to identify patient and doctor
5" W x 3" L
White 65# cover stock, printed in black ink
Custom Multi-Purpose Sales Books, Classic Design, Large Format, 2 Parts, 1 Color Printing, 5.5" x 8.5"500/Pack
Item #: 901-D552
Take complete orders: Preprinted areas simplify write-ups of customer information, salesperson, description of items, payment method & more
Get the details: 17 lines enable even the biggest orders to fit on a single page
Stay organized: Bottom copy stays bound in book for a permanent record
