Confidentially sign in your patients. Forms limit access to personal information as required by HIPAA. Patient signs in and waits to be called by name or number. Office staff removes numbered label strip with patient name and adheres it to patient chart to help improve record keeping. Once label strips have been removed, the patient information is now protected behind special backing paper. The sign-in form also provides confidential daily patient log. Forms numbered 1 - 23. Form Size: 8.5 x 11.63; Number of Columns: 6; Forms Per Page: 1; Number of Entry Lines: 23.
Products specifications
| Attribute name |
Attribute value |
|
Copy Types
|
Two-Part Carbon |
|
Finish
|
Label Stock |
|
Global Product Type
|
Forms-Medical Admissions |
|
Form Size
|
8.5 x 11.63 |
|
Forms Per Page
|
1 |
|
Number of Entry Lines
|
23 |
|
Form Quantity
|
125 |
|
Sheet Size
|
8.5 x 11.63 |
|
Principal Heading(s)
|
Date; Please Print Name; Arrival Time; Appt. Time; Appointment With; New Patient; Any Changes Since Last Visit |
|
Number of Columns
|
6 |
|
Layout
|
One Form per Sheet |
|
Numbering
|
Preprinted Entry Lines |
|
Total Number of Entries per Book
|
2,875 |
|
Print and Ruling Color(s)
|
Black |
|
Numbering Color(s)
|
Black |
|
Pre-Consumer Recycled Content Percent
|
0% |
|
Post-Consumer Recycled Content Percent
|
0% |
|
Total Recycled Content Percent
|
0% |
|
Paper Color(s)
|
Salmon |
