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Product details
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.
- 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.
| Item Specifications | |
|---|---|
| Global Product Type | Forms-Medical Admissions |
| Principal Heading(s) | Date, Please Print Name, Arrival Time, Appt. Time, Appointment With, New Patient, Any Changes Since Last Visit |
| Copy Types | Two-Part Carbon |
| Form Size | 8.5 x 11.63 |
| Number of Columns | 6 |
| Forms Per Page | 1 |
| Number of Entry Lines | 23 |
| Form Quantity | 125 |
| Sheet Size | 8.5 x 11.63 |
| Layout | One Form per Sheet |
| Numbering | Preprinted Entry Lines |
| Total Number of Entries per Book | 2, 875 |
| Paper Color(s) | Green |
| Print and Ruling Color(s) | Black |
| Numbering Color(s) | Black |
| Finish | Label Stock |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Manufacturer Info | |
|---|---|
| Brand | Tabbies® |
| Manufacturer | TABBIES |
| Model Number | 14532 |
| Part Number | 217695 |
| Retail UPC | 084371145324 |
| Carton UPC | 10084371145321 |
| Country of Origin | US |
| UNSPSC | 14111806 |
| Dimensions / Specifications | |
|---|---|
| Unit of Measure | PK (Pack) |
| Item Dimensions | 8.5 in. x 1.75 in. x 11.625 in. (W x H x L) |
| Item Weight | 4.95 lbs. |
| Carton Pack Quantity | 6 PK |
| Carton Pack Dimensions | 9.0 in. x 11.0 in. x 12.0 in. (W x H x L) |
| Carton Pack Weight | 33.0 lbs. |
| This item is sold by the PK which contains 125 EA | |
| Shipping Info | |
|---|---|
| UPS Shippable | Yes |
| Air Shippable | Yes |
| Additional Info | |
|---|---|
| Green Product | No |
| EPA/CPG Certified | No |
| Recycled | No |
| Warranty | No |
| State Restricted | No |
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Shipping
We offer free shipping on orders over $75. Items that ship freight, including furniture, oversized items, hazardous items, and products with a combined weight of over 600 lbs do not qualify for free shipping and will be charged a fee of $115 for the first item.
Most of our customers receive their items within 1-3 business days of placing an order. However, delivery times may vary based on factors such as product availability, delivery location, and whether an item must be shipped freight. We cannot guarantee any specific delivery date.
At this time, we do not offer expedited shipping.
We do not ship internationally or to U.S. territories, PO Boxes, APO or FPO addresses.
You will receive a shipping confirmation email with tracking information once your order has shipped, if tracking is available. Please allow 24 hours for the tracking information to be updated.
If your order is damaged during shipping, please contact our customer service team as soon as possible so that we can assist you. Please note that any visible damage should be noted on the bill of lading/delivery ticket before signing for the shipment.
Returns
We accept returns of most new, unopened items within 30 days of delivery for a full refund. Some items may be subject to a restocking fee. We also offer exchanges for items that are defective or damaged.
To initiate a return, please contact our customer service team. You will be provided with a return shipping label and instructions for returning the item.
We cannot accept returns of certain items, including custom orders, final sale items, items listed as non-returnable on the product page, and hazardous materials.
Once we receive your returned item, we will process your refund or exchange within 5-7 business days. Please note that it may take additional time for the refund to be reflected on your credit card statement.
Original shipping costs are non-refundable, unless the item is defective or damaged.
You will be responsible for paying for the return shipping costs, unless the item is defective or damaged.
Yes, you can return a gift as long as it meets the requirements of our return policy. Please note that the refund will be issued to the original payment method.
Yes, we offer exchanges for defective or damaged items. If you would like to exchange an item, please initiate a return and place a new order for the desired item.
Orders cannot be canceled once they have been submitted. If you are no longer in need of the item and would like to return it, please contact our customer service team to initiate a return once you have received the item.
Any question?
If we still haven't answered your question, you can contact us below and we will get back to you as soon as possible.
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