Page 32 of replacement superbill forms
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Boorum & Pease Record Book, 7 5/8" x 12 1/2", Green/Red, 250 Sheets/Book (67 1/8-500-R)
Item #: 901-2667668
Timeless book features acid-free paper, permanent, waterproof ink, smyth-sewn binding, numbered pages and a Table of Contents page.
Brand: Boorum & Pease
Manufacturer: Esselte Pendaflex Corp.
$150.99
1-2 each
Save 23%
$115.99
3+ each
Custom Service Orders, HVAC, w/Checklist, Large Format, 4 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D65014
EPA checklist ensures you're in compliance with regulations on every job
Lots of checkboxes & specialized fields let you write up every job quickly & include all the details
Last part is durable tag stock, useful for tracking jobs & calculating profit.
Custom 2-Sided Pegboard Account Cards, 5-1/2" x 8-1/2", 500 Cards per Pack
Item #: 901-QFN101291R
For use with a pegboard system
5-1/2" W x 8-1/2" L
White 80# cover stock, printed in black ink
ComplyRight 3-Part Employee Warning Notice, Carbonless, Pack of 50 (A2191)
Item #: 901-2548965
Includes action to be taken, as well as explains the consequences of repeat offenses
Includes ComplyRight™ tips for optimal, compliant use
Give one copy to the employee and keep the other for recordkeeping
$75.99
Per each
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
ComplyRight Canada Federal and Province (English) - Subscription Service, Saskatchewan (U1200FCANSK)
Item #: 901-1949305TFP
Laminated English Canadian Federal and Province posters with automatic updates
Includes one year of legal monitoring for 365 days of worry-free posting compliance
Service provides replacement posters for mandatory changes for 12 months, with free UPS delivery
$59.99
Per each
Medical Arts Press® Growth Chart, Boys 2-20 Years
Item #: 901-20226
Type of form: Growth chart
200 per pack
Size: 8 1/2" x 11"
$36.09
1-2 pack
($0.18/PAD)
Save 14%
$30.99
3+ pack
($0.15/PAD)
Custom Work Orders, Carbonless, Large Format, 2 Parts, 1 Color Printing, 8 1/2" X 11" ,250/Pack
Item #: 901-D65442
25 lines for materials, plus space for labor, description of work & other costs
Last part is durable tag stock, useful for tracking jobs & calculating profit.
Track customer acceptance: Signature line for customer authorization prevents disputes
Custom Garage Repair Orders, Booked 3 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D25453
Take complete orders: Preprinted areas for vehicle information, description of work, labor and more
Track customer acceptance: Signature line for customer authorization prevents disputes
Stay organized: Bottom copy stays bound in book for a permanent record; 50 sets per book
Custom HVAC Service Orders - Side-Stub, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D65343
Includes Environmental check list
Authorized signature line included
Sturdy: Last part is sturdy manila tag
ComplyRight New Mexico Job Application, Pack of 50 (A2179NM)
Item #: 901-1949602TFP
Written by Employment Attorneys to ensure compliance with your state laws
Gathers the maximum amount of information and exposes “red flags” without crossing into illegal territory
Includes tip sheet with HR best practices and compliance guidelines
$56.29
Per each
Custom Classic Large Sales Orders, 4 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D534
Extra long, record up to 27 items
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
Custom Classic Large Sales Orders, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D533
Extra long, record up to 27 items
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
ComplyRight™ Connecticut Job Application, Pack of 50 (A2179CT)
Item #: 901-1182917EDI
Written by Employment Attorneys to ensure compliance with your state laws
Gathers the maximum amount of information and exposes “red flags” without crossing into illegal territory
Includes tip sheet with HR best practices and compliance guidelines
$73.19
Per pack
ComplyRight™ Orthodontic Case Envelo-File®
Item #: 901-AR1048
Convenient, secure patient folders designed specifically for orthodontists’ offices
Keeps all case documentation for patients in one secure place
Sections to record presenting oral condition, medical history, model and x-rays, markings before treatment plan and treatment plan
$56.99
Per pack
($2.28/EACH)
Quill Brand® Special-Size Multi-Part Carbonless Forms, 9-1/2 x 5-1/2", 3200 Sheets/Carton
Item #: 901-710833
Business paper is perfect for printing receipts that require two copies
Paper dimensions: 5.5"W x 9.5"L
Paper weight: 15 lbs.
$127.99
Per carton
Boorum & Pease 21 Series Record Book, 8.13"W x 10.38"H, Black, 75 Sheets/Book (21-150-R)
Item #: 901-719682
Elegant black cover with reinforced red spine and corners
Includes 150 numbered pages
Overall dimensions: 8.13"W x 10.38"H
$94.99
Per each
Custom Carbonless 2-Part Equine Superbills, 8-1/2" x 11", 250 Sets per Pack
Item #: 901-QFN103481R
Use to provide costs and services to patients
8-1/2" W x 11" L
2-part, white/canary, carbonless; printed in black ink
Rediform Emerald Series Record Book, 6.25"W x 9.63"H, Green, 100 Sheets/Book (56521)
Item #: 901-388158
Green canvas hardcover and silk screened title
Includes 200 numbered pages with blue ruling and red margin
Overall dimensions: 6.25"W x 9.63"H
$37.99
Per each
Custom Proposals, Classic Design, Large Format, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,250/Pack
Item #: 901-D1183
Customer sign-off line & professionally worded disclaimer prevent misunderstandings about acceptance & terms of proposal
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
Custom Cash Receipt Book, 4-to-a-page, Duplicate, 300 Sets/Book
Item #: 901-TCRB1142
4-Up
Duplicate
300 sets per book
Custom Repair Orders, Garage, Carbon, Side-Stub, Large Format, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pk
Item #: 901-D6553
27 lines for parts & accessories, plus handy odometer in/out boxes & "Save Old Parts" question box for use when scheduling maintenance
Track customer acceptance: Signature line for customer authorization prevents disputes
Consecutively numbered for easy recordkeeping
ComplyRight™ Illinois Job Application, Pack of 50 (A2179IL)
Item #: 901-1182911EDI
Written by Employment Attorneys to ensure compliance with your state laws
Gathers the maximum amount of information and exposes “red flags” without crossing into illegal territory
Includes tip sheet with HR best practices and compliance guidelines
$55.09
Per pack
Medical Arts Press® Financial Agreement and Insurance Assignment; 4x5-1/2" Bond Non-Personalized
Item #: 901-33404
100 sheets per pad
Pad size: 4 x 5-1/2 inches
$5.99
5+ pad
