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Medical Arts Press® Dental Records Release Request Slip

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Item # 174-13128

$3.00
per Pad
When you buy 40+

Pad

Order in multiples of 5.

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Buy more, save more!: $6.00; Buy 10$4.00; Buy 20$3.50; Buy 40+$3.00

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Description Specifications

A quick way to request release of a patients' dental records to you. Your name, address and phone number (5-line maximum) will be imprinted on white 20 lb. bond. 100 sheets per pad. Size: 4" x 5-1/2".

Product Information: Form Type :

Clinical; Format :

Dental Exam Chart; Sheet Size :

4" x 5-1/2"; Form Size :

4" x 5-1/2"; Media Quantity :

500; Binding Type :

Padded; Paper Color :

White; Number of Parts :

1; Carbonless :

No; # Up Per Sheet/Page :

1; NCR Paper :

No; Numbered :

No; Holes Punched :

None; Personalization :

Yes; Security Features :

No
Miscellaneous: Brand Name :

Medical Arts Press; Country of Origin :

USA
Weight: Weight :

1.00 lbs. per Pad