Item # 174-15179 Model # 15179
$40.00
per Pack
When you buy 8+
- $50.00
- Buy 2$47.00
- Buy 4$44.00
- Buy 8+$40.00
Your delivery dates will be verified at checkout
Privacy Sign-in sheets that provide the level of privacy that patients expect.
Sheets provided for patient name, arrival time, appointment time, doctor or dept, indicate yes or not for any changes to information and numbering system if office chooses to use
Patient signs on removable strips that have adhesive backs for attaching to patient charts to improve record keeping
Once sheet is full, perforated snap-set provides a confidential record of the daily patient log
20 lines per form, 125 forms per package, size: 8-1/2 x 11"
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Product Information
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Form Type :
Clinical
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Format :
Sign In Sheet
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Sheet Size :
8-1/2" x 11"
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Lines :
20
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Form Size :
8-1/2" x 11"
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Media Quantity :
125
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Binding Type :
Loose
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Paper Color :
White
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Number of Parts :
2
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Carbonless :
Yes
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# Up Per Sheet/Page :
1
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NCR Paper :
Yes
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Numbered :
No
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Holes Punched :
None
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Personalization :
No
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Security Features :
Yes
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Miscellaneous
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Brand Name :
Medical Arts Press
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Country of Origin :
USA
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Weight
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Weight :
5.60 lbs. per Pack
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