BLACKHAWK Inc



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Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Blue Sheets, 125 Forms Total

SKU: TAB14531

  • Forms limit access to personal information as required by HIPAA.
  • Once label strip is removed the patient information is now protected behind special backing paper.
  • Can be used as confidential daily patient log as well as sign-in sheet.
Weight:4.95 lbs.
Unit of Measure:PK
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    TAB14530
    Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Salmon Sheets, 125 Forms Total

Description

Patient Sign-In Label Forms, Two-Part Carbon, 8.5 x 11.63, Blue Sheets, 125 Forms Total
  • Forms limit access to personal information as required by HIPAA.
  • Once label strip is removed the patient information is now protected behind special backing paper.
  • Can be used as confidential daily patient log as well as sign-in sheet.

Product Details

Global Product Type Medical Admission Forms
Form Type Details Medical Admission
Dated/Undated Undated
Forms Per Page 1
Format Indicator Unbound
Copy Types Two-Part Carbon
Color Family Blue
Form Size 8.5 x 11.63
Sheet Size 8.5 x 11.63
Form Quantity (Total) 125
Principal Heading(s) Date,Please Print Name,Arrival Time,Appt. Time,Appointment With,New Patient,Any Changes Since Last Visit
Columns per Sheet 6
Number of Entry Lines 23
Paper Color(s) Blue
Print and Ruling Color(s) Black
Numbering Color(s) Black
Product Biodegradability in Days 0
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Special Features Blue Sheets

Shipping Weight & Dimensions

Box Weight0.0 lbs.
Box Height0.0 in
Box Length0.0 in
Box Width0.0 in
Carton Height11.0 in
Carton Length
Carton Width9.0 in
Item Weight4.95 lbs.
Item Height1.75 in
Item Length11.625 in
Item Width8.5 in

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