Medical Filling, Forms & Equipment
Showing all 68 results
-
ADA Dental Claim Form – 2024 (Model # IH60-ADA2024)
$40.00 Add to cartADA Dental Claim Form – 2024 (Model # IH60-ADA2024)
- 500 Forms/Order
- ADA Dental Claim Form – 2024 Edition
- Complies with updated American Dental Association requirements effective January 1, 2024
- Ensures consistency with HIPAA standard electronic dental claim transaction
$40.00 -
Adhesive Telephone Message and Response Slips (Model # IHF287)
$23.88 Add to cartAdhesive Telephone Message and Response Slips (Model # IHF287)
- 100 Messages slips/package
- Adhesive Patient Message Form
- Complete the message portion when a patient calls
- Affix the top portion to the outside of the patient chart if a response is required
- After follow-up, remove and attach inside the chart to progress note or telephone message carrier in shingle fashion
- For full view, remove the remaining adhesive strip and affix directly
- Size: 8″ w x 3 1/2″ h
$23.88 -
Adult Patient’s Check List for Medical History (Model # IH25-8093-01)
$42.50 Add to cartAdult Patient’s Check List for Medical History (Model # IH25-8093-01)
- 250 Adult Patient’s Check List for Medical History Forms/Order
- Flip-up style design printed front and back and head to foot for flip-up style filing
- Includes review of symptoms, medications, past illnesses, hospitalizations, and allergies
- Printed in black ink on 60 lb. white book stock
- Two-hole punched at the top and bottom
- Size: 8 1/2″ w x 11″ h
$42.50 -
Alter-Resistant Rx Prescription Blanks & Pads (Model # IH25-8293)
$70.00 Select options This product has multiple variants. The options may be chosen on the product pageAlter-Resistant Rx Prescription Blanks & Pads (Model # IH25-8293)
- 500 Alter-Resistant Rx Prescription Blanks and Pads/Order
- Tamper-resistant design with green or blue background to detect erasures and alterations
- Includes “VOID” pantograph, invisible ultra-violet fibers, and protection against bleach or solvent washing
- Security features listed on back; background pattern appears on both sides of the first part
- Two-part format includes screened “VOID” copy printed across the second part
- Available in horizontal or vertical format; may be faxed or copied for record keeping
- Meets Medicaid Security Requirements (October 1, 2008 standard)
- Available in one- or two-part formats; Jumbo size also available
- Alter-resistant blank sheet (8 1/2″ w x 11″ h) available for laser printers
- Standard size: 5 1/2″ w x 4 1/4″ h
- For all custom product inquiries and orders, please contact customer service at 1-800-809-5131
$70.00 -
Antimicrobial Clipboards with Color Clasp, Legal Size (Model # IH58-M9461LC)
$66.55 Select options This product has multiple variants. The options may be chosen on the product pageAntimicrobial Clipboards with Color Clasp, Legal Size (Model # IH58-M9461LC)
- 1 Antimicrobial Clipboard with Color Clasp/Order
- Legal size clipboard constructed of durable, lightweight ABS plastic that resists breaking, cracking, and chipping
- Features Microban® antimicrobial protection to inhibit bacterial growth and reduce stains and odors
- Steel pressure clip holds up to 75 sheets of paper
- Pre-drilled 3/8″ hole at the top for convenient hanging
$66.55 -
Antimicrobial Clipboards with Color Clasp, Letter Size (Model # IH58-M9461C)
$49.65 Select options This product has multiple variants. The options may be chosen on the product pageAntimicrobial Clipboards with Color Clasp, Letter Size (Model # IH58-M9461C)
- 1 Antimicrobial Clipboard with Color Clasp/Order
- Letter size clipboard constructed of durable, lightweight ABS plastic that resists breaking, cracking, and chipping
- Features Microban® antimicrobial protection to inhibit bacterial growth and reduce stains and odors
- Steel pressure clip holds up to 75 sheets of paper
- Pre-drilled 3/8″ hole at the top for convenient hanging
$49.65 -
Authorization & Acknowledgment Forms (Model # IH25-8401)
$12.00 Add to cartAuthorization & Acknowledgment Forms (Model # IH25-8401)
- 100 Forms/Order
- Authorization and Acknowledgment Forms
- Authorization to release medical records
$12.00 -
Chiropractic Patient Information Form (Model # IH30-1001)
$70.00 Add to cartChiropractic Patient Information Form (Model # IH30-1001)
- 100 Chiropractic Patient Information Forms/Package
- Designed specifically for chiropractic offices
- Includes patient, insurance, reason for visit, and emergency information on the front
- Back includes health and medication questionnaire, account information, and assignment and release
- Printed in purple and black ink
- Heavyweight 60 lb. white bond
- Two-hole punched at the top and left side
- Size: 8 1/2″ w x 11″ h
$70.00 -
CMS 1500 Claim Form Jumbo Envelope – Self Seal Flap (Model # IH36-9101)
$58.00 Add to cartCMS 1500 Claim Form Jumbo Envelope – Self Seal Flap (Model # IH36-9101)
- 100 Envelopes/Order
- Self-Seal CMS 1500 Window Envelope
- Insurance carrier’s name and address show through the window
- 28 lb. white wove stock with green border and inside security tint
- Top self-seal flap
- Window aligns with insurance carrier’s address
- Size: 9″ w x 12 5/8″ h
$58.00 -
CMS 1500 Claim Form Jumbo Envelope (Model # IHE1500)
$80.00 Add to cartCMS 1500 Claim Form Jumbo Envelope (Model # IHE1500)
- 100 CMS 1500 Claim Form Jumbo Envelopes/Package
- Full-size insurance envelope with open side with gummed flap designed for CMS 1500 Claim Form submission
- Custom window placement displays insurance carrier’s name and address
- Holds up to 50 claim forms to the same carrier
- Recommended for use with claim forms without bar codes
- Saves time, postage, and labor costs
- Size: 9″ h x 13″ w
$80.00 -
CMS 1500’s – For Laser Printers (Model # IH60-8648R-L-B)
$29.50 Add to cartCMS 1500’s – For Laser Printers (Model # IH60-8648R-L-B)
- 500 CMS 1500 Claim Forms – Laser Printer Format/Package
- 1-part laser 02-12 version
- Printed in OCR red scannable format with instructions on the back
- Forms can be personalized
- Size: 8 1/2″ w x 11″ h
$29.50 -
CMS 1500’s – Multiple Part Sets (Model # IH60-8650R-02)
$55.00 Add to cartCMS 1500’s – Multiple Part Sets (Model # IH60-8650R-02)
- 250 CMS 1500 Claim Forms/Order
- Two-part NCR (clean carbon) – 02-12 version
- Printed in OCR red scannable format with instructions on the back
- Non-personalized
- Size: 8 1/2″ w x 11″ h plus 5/8″ stub top
$55.00 -
Comprehensive Health History and Physical Exam Forms (Model # IH19-99204)
$50.00 Add to cartComprehensive Health History and Physical Exam Forms (Model # IH19-99204)
- 100 Comprehensive Health History and Physical Exam Forms/Package
- Four-page form designed to comply with CMS documentation requirements
- Captures detailed information including past family and medical history, hospitalizations, allergies, medications, problems, travel, immunizations, physical exams, lab results, and treatment plan
- Book style format
- Two-hole punched at the top
- Size: 17″ w x 11″ h (8 1/2″ w x 11″ h when folded)
$50.00 -
Comprehensive Health History Questionnaire (Model # IH19-711)
$97.00 Select options This product has multiple variants. The options may be chosen on the product pageComprehensive Health History Questionnaire (Model # IH19-711)
- 100 Comprehensive Health History Questionnaires/Package
- Four-page record organized to capture past and present medical problems, family history, and nutrition
- Summarizes patient data for quick and easy review
- Available in both male and female versions
- Two-hole punched at the top for convenient filing
- Folded size: 8 1/2″ w x 11″ h (includes 5/8″ stub for detaching pages)
$97.00 -
Comprehensive Physical Examination (Age 6 to Young Adult) (Model # IH19-785)
$28.00 Add to cartComprehensive Physical Examination (Age 6 to Young Adult) (Model # IH19-785)
- 100 Comprehensive Physical Examination Forms – /Package
- Provides a complete physical examination organized by body system (age 6 to young adult)
- Includes gender-specific sections and ample space for physician notes
- Two-hole punched for side filing
- Size: 8 1/2″ w x 11″ h
$28.00 -
Confidential Patient Sign-In Sheets (Model # IH58-8430)
$117.05 Add to cartConfidential Patient Sign-In Sheets (Model # IH58-8430)
- 250 Confidential Patient Sign-In Sheets/Package
- Meets patient privacy and confidentiality expectations
- Allows patients to sign in without viewing other patient information
- Each visit line strip can be removed by front office staff
- Completed sheet can be peeled back to reveal collected information
- Includes a New Patient check box column
- One package accommodates 5,750 patient visits
- Forms with salmon background available for immediate shipment
$117.05 -
Dental Charts & Treatment Records – Treatment Record – 2 Holes Punched Top – 8 1/2″ w. x 10″ h. (Model # IH28-9501)
$45.00 Add to cartDental Charts & Treatment Records – Treatment Record – 2 Holes Punched Top – 8 1/2″ w. x 10″ h. (Model # IH28-9501)
- 250 Dental Charts and Treatment Records/Package
- Designed for comprehensive documentation of dental treatments and patient information
- Printed on durable 67 lb. heavyweight white stock for long-lasting use
- Standard letter size for easy filing and compatibility with most chart systems
- Size: 8 1/2″ w x 11″ h
$45.00 -
Dental Charts & Treatment Records (Model # IH28-0000)
$45.00 Select options This product has multiple variants. The options may be chosen on the product pageDental Charts & Treatment Records (Model # IH28-0000)
- 250 Dental Charts and Treatment Records/Package
- Designed for comprehensive documentation of dental treatments and patient information
- Printed on durable 67 lb. heavyweight white stock for long-lasting use
- Standard letter size for easy filing and compatibility with most chart systems
- Size: 8 1/2″ w x 11″ h
$45.00 -
Flip-Up Veterinary Letter Size Chart Dividers – Right Side Tabs (Model # IH21-7716-R1)
$70.00 Add to cartFlip-Up Veterinary Letter Size Chart Dividers – Right Side Tabs (Model # IH21-7716-R1)
- 100 Flip-Up Veterinary Letter Size Chart Dividers – Right Side Tabs/Package
- Features a Patient Health Record section for recording client and pet information, immunization history, problems, and medications
- Reverse side provides continuation space for problem and medication lists
- Flip-up design reveals stored data for efficient record organization and easy access
- Constructed of durable letter-size stock with 1/4 cut right side tabs coated in colored mylar for long-lasting use
- Size (installed): 8 1/2″ w x 11″ h
$70.00 -
Growth Charts (Model # IH26-714)
$17.00 Select options This product has multiple variants. The options may be chosen on the product pageGrowth Charts (Model # IH26-714)
- 100 Growth Charts/Package
- Includes both WHO (0–2 years) and CDC (birth-24-months & 2–20 years) growth charts for boys and girls
- WHO charts include: head circumference-for-age, weight-for-length, and length-for-age & weight-for-age percentiles
- CDC charts include: stature-for-age, weight-for-age, and BMI-for-age percentiles
- All four charts printed in different colors for easy differentiation
- Two-hole punched at the top for filing convenience
- Size: 8 1/2″ w x 11″ h
$17.00 -
Gynecological/Obstetrical History (Model # IH19-770)
$73.00 Add to cartGynecological/Obstetrical History (Model # IH19-770)
- 100 Gynecological/Obstetrical History Forms/Package
- Two-part clean carbon record for capturing comprehensive patient history
- Includes general, gynecological, obstetrical, and menstrual history
- Supports a complete and up-to-date record for the health delivery team
- Printed in blue and black ink
- Two-hole punched at the top
- Size: 8 1/2″ w x 11″ h
$73.00 -
History of This Pregnancy and Physical Examination (Model # IH19-771)
$73.00 Add to cartHistory of This Pregnancy and Physical Examination (Model # IH19-771)
- 100 History of This Pregnancy and Physical Examination Forms/Package
- Two-part clean carbon record
- Captures mother’s history since LMP and medications taken
- Includes complete physical with extensive pelvic exam
- Printed in blue and black ink
- Size: 8 1/2″ w x 11″ h plus 5/8″ stub top
$73.00 -
Journal of Daily Charges & Cashiering Journal (Model # IH42-9010-04*)
Price range: $89.00 through $117.00 Select options This product has multiple variants. The options may be chosen on the product pageJournal of Daily Charges & Cashiering Journal (Model # IH42-9010-04*)
- 100 Journal of Daily Charges & Cashiering Journals/Package
- Available with four distribution columns or without distribution for smaller practices
- Includes summary sheets providing cumulative monthly and yearly analysis of charges, receipts, and adjustments (January–December)
- Ideal for maintaining accurate daily financial records and simplifying bookkeeping
Price range: $89.00 through $117.00 -
Lab Report Carrier (Model # IH26-7113)
$55.00 Add to cartLab Report Carrier (Model # IH26-7113)
- 250 Lab Report Carriers/Order
- Allows shingling of lab reports chronologically from bottom to top
- Printed one side in black ink on heavy white stock
- Two-hole punched at the top
- Attach reports with clear tape
- Size: 8 1/2″ w x 11″ h
$55.00 -
Laser Statement – Credit Card Format (Model # IH13-1012CC)
$59.50 Select options This product has multiple variants. The options may be chosen on the product pageLaser Statement – Credit Card Format (Model # IH13-1012CC)
- 500 Sheets/Order
- Laser Printer Statements – Credit Card Format
- Includes credit card and change of address information on the reverse side
- Front notation area provided for address changes
- Perforation for tearing off and returning the top portion
- One part, 24 lb. bond
- Size: 8 1/2″ w x 11″ h
$59.50 -
Laser Statement – Open Format (Model # IH13-1012C)
$50.00 Select options This product has multiple variants. The options may be chosen on the product pageLaser Statement – Open Format (Model # IH13-1012C)
- 500 Sheets/Order
- Laser Statement – Open Format
- Laser printer paper with open format design
- Includes perforation for tearing off and returning top portion
- One part, 24 lb. bond
- Size: 8 1/2″ w x 11″ h
$50.00 -
Medication List (Model # IH25-7202-01)
$42.50 Add to cartMedication List (Model # IH25-7202-01)
- 250 Medication List Forms/Order
- Flip-up style allows viewing of all current medications and refills at a glance
- Printed head to foot for flip-up filing
- Two-hole punched at the top and bottom
- Size: 8 1/2″ w x 11″ h
$42.50 -
Out-of-Office Daily Journal (Model # IH74-9050)
$22.00 Add to cartOut-of-Office Daily Journal (Model # IH74-9050)
- 100 Out-of-Office Daily Journals/Package
- Three-month supply of pocket-size design with space for doctor’s name and date on the front
- CPT procedure codes printed on the back
- Inside section allows assistants to record patient appointments and doctors to mark CPT codes for services performed
- Data can be easily transferred into the accounting system
- Folded size: 3 1/2″ w x 7″ h
$22.00 -
Patient Information Form – Easy To Read (Model # IH58-8427)
$25.00 Add to cartPatient Information Form – Easy To Read (Model # IH58-8427)
- Minimum order: 100 Patient Information Forms
- Easy-to-read, two-color design covering patient and responsible party information
- Printed both sides in black and lavender ink
- Two-hole punched at the top and bottom
- Size: 8 1/2″ w x 11″ h
$25.00 -
Patient Information Form (Model # IH58-8421-01)
$15.00 Add to cartPatient Information Form (Model # IH58-8421-01)
- 100 Patient Information – Payment Assignment and Information Release Forms/Order
- Includes both Payment Assignment and Information Release statements
- Printed in black ink on white bond
- Two-hole punched at the top
- Size: 8 1/2″ w x 11″ h
- Spanish version available upon request
$15.00 -
Patient Information Form (Model # IH58-8425)
$14.00 Add to cartPatient Information Form (Model # IH58-8425)
- 100 Patient Information Forms/Pad
- One-part, two-color form that is easy to read and follow
- Updated to include patient’s cell phone number, fax number, and email address
- Two-hole punched at the top
- Size: 8 1/2″ w x 11″ h
$14.00 -
Patient Instruction Record – “Write-It-Once” (Model # IH25-8297)
Read morePatient Instruction Record – “Write-It-Once” (Model # IH25-8297)
- 100 Patient Instruction Record “Write-It-Once” Forms/Order
- Spot-carbonized design automatically duplicates patient instructions onto Progress Notes
- Ensures accurate documentation of instructions for both patient and provider records
- Provides a permanent copy of communication and care directives
- Personalized in black ink to meet your practice needs
- For ordering specifications, pricing, and customization, please contact Customer Service at 1-800-242-2376
-
Patient Registration Information Form (Model # IH58-842)
Price range: $12.65 through $21.90 Select options This product has multiple variants. The options may be chosen on the product pagePatient Registration Information Form (Model # IH58-842)
- 100 Patient Registration Information Forms/Package
- Includes sections for patient, responsible party, referring physician, and emergency contact information
- Updated layout includes patient cell phone, fax number, and email address fields
- Available printed in blue and black ink or black ink only on white bond
- Two-hole punched at the top for convenient filing
- Size: 8 1/2″ w x 11″ h
Price range: $12.65 through $21.90 -
Personnel Forms (Model # IH72-131-2025)
$6.75 Add to cartPersonnel Forms (Model # IH72-131-2025)
- 25 Personnel Forms available in a variety of standard formats for immediate delivery
- Forms can be customized to meet your specific requirements
- Actual samples available upon request
- For custom product inquiries or orders, contact Customer Service at 1-800-809-5131
$6.75 -
Personnel Forms For The Medical Office (Model # IH72-100)
Price range: $20.50 through $150.00 Select options This product has multiple variants. The options may be chosen on the product pagePersonnel Forms For The Medical Office (Model # IH72-100)
- 25 Personnel Forms for the Medical Office/Package
- Comprehensive selection of ready-to-use personnel forms designed for medical office administration
- Forms can be customized to meet your specific office requirements
- For all custom product inquiries and orders, please contact customer service at 1-800-809-5131
Price range: $20.50 through $150.00 -
Physical Examination Form – Male/Female Combo (Model # IH19-744-2)
$28.00 Add to cartPhysical Examination Form – Male/Female Combo (Model # IH19-744-2)
- 100 Physical Examination Forms – Male/Female Combo/Order
- Book style format printed head to foot for flip-up filing
- Two-hole punched at the top
- Printed in green ink
- Size: 8 1/2″ w x 11″ h
$28.00 -
Physical Examination Forms – Male or Female (Model # IH19-762)
$28.00 Select options This product has multiple variants. The options may be chosen on the product pagePhysical Examination Forms – Male or Female (Model # IH19-762)
- 100 Physical Examination Forms
- Designed to efficiently record and review patient examination information
- Reduces the amount of writing required during exams
- Two-hole punched available upon request
- Size: 8 1/2″ w x 11″ h
$28.00 -
Pregnancy Flow Sheet (Model # IH19-773)
$86.00 Add to cartPregnancy Flow Sheet (Model # IH19-773)
- 100 Pregnancy Flow Sheet Forms/Package
- Three-part clean carbon pull-apart form
- Tracks maternal and fetal vital signs, lab results, complaints, and treatments
$86.00 -
Pregnancy Risks and Problems (Model # IH19-772)
$73.00 Add to cartPregnancy Risks and Problems (Model # IH19-772)
- 100 Pregnancy Risks and Problems Forms/Package
- Two-part clean carbon record
- Summarizes risks and problems for forwarding to hospital or birthing center at approximately 36 weeks
- Printed in blue and black ink
- Two-hole punched at the top
- Size: 8 1/2″ w x 11″ h plus 5/8″ stub top
$73.00 -
Progress Note Dividers – Book Style (Model # IH22-7212P)
$70.00 Select options This product has multiple variants. The options may be chosen on the product pageProgress Note Dividers – Book Style (Model # IH22-7212P)
- 100 Progress Note Dividers – Book Style/Package
- Book style design allows pages to be filed and extracted easily without disassembling charts
- Manufactured with 1/6 cut, 1/2″ side tabs printed on one side for clear section labeling
- Includes 1″ embedded fastener installed at the top for secure document organization
- Dividers assemble easily into existing or new file folders
$70.00 -
Progress Note Dividers – Flip-Up Bottom Tab (Model # IH21-7602-01)
$70.00 Add to cartProgress Note Dividers – Flip-Up Bottom Tab (Model # IH21-7602-01)
- 100 Progress note dividers/Order
- Progress Note Dividers in flip-up style
- Use on either side of chart to file and extract pages without disassembly
- 1/6 cut, 3/8″ bottom tabs, printed one side only
- Most dividers include a 1″ embedded fastener installed at the top
- Easily assembled into existing or new file folders
$70.00 -
Progress Notes – Open Format w/Allergy Notation (Model # IH25-713)
$62.50 Select options This product has multiple variants. The options may be chosen on the product pageProgress Notes – Open Format w/Allergy Notation (Model # IH25-713)
- 250 Progress Notes – Open Format with Allergy Notation/Package
- Four lines per inch for clear handwritten entries
- Includes columns for date, problem number, notes, and allergy notation
- Printed in black and red ink on 60 lb. white book stock
- Two-hole punched on both sides for book style or top and bottom for flip-up style filing
- Size: 8 1/2″ w x 11″ h
$62.50 -
Progress Notes – History & Physical (Model # IH19-99203)
$28.00 Add to cartProgress Notes – History & Physical (Model # IH19-99203)
- 100 Forms/Order
- History and Exam Form
- Organized to collect history and exam data, and record diagnosis and treatment plan
- Printed on 60 lb. white book stock in black ink
- Two-hole punched top and bottom for flip-up style
- Size: 8 1/2″ w x 11″ h
$28.00 -
Progress Notes – Open Format for Handwritten Notes (Model # IH25-712)
$42.50 Select options This product has multiple variants. The options may be chosen on the product pageProgress Notes – Open Format for Handwritten Notes (Model # IH25-712)
- 250 Progress Notes – Open Format for Handwritten Notes/Package
- Features four lines per inch for clear handwritten entries
- Includes columns for date, problem number, and notes
- Printed in black ink on 60 lb. white book stock
- Two-hole punched on both sides for book style or top and bottom for flip-up style filing
- Size: 8 1/2″ w x 11″ h
$42.50 -
Progress Notes – Open Format for Typed Notes (Model # IH26-810)
$42.50 Select options This product has multiple variants. The options may be chosen on the product pageProgress Notes – Open Format for Typed Notes (Model # IH26-810)
- 250 Progress Notes – Open Format for Typed Notes/Package
- Features six typing lines per inch for clean, structured entries
- Includes columns for date, problem number, and notes
- Printed in black ink on 60 lb. white book stock
- Two-hole punched on both sides for book style or top and bottom for flip-up style filing
- Size: 8 1/2″ w x 11″ h
$42.50 -
Progress Notes – Split Page (Model # IH25-807)
Price range: $42.50 through $47.50 Select options This product has multiple variants. The options may be chosen on the product pageProgress Notes – Split Page (Model # IH25-807)
- 250 Progress Notes – Split Page/Package
- Split page layout ideal for organizing multiple entries
- Four lines per inch for clear handwritten notes
- Includes columns for date, problem number, and notes
- Printed in black ink on 60 lb. white book stock
- Two-hole punched on both sides for book style or top and bottom for flip-up style filing
- Size: 8 1/2″ w x 11″ h
Price range: $42.50 through $47.50 -
Progress Notes – w/Vital Signs (Model # IH19-700)
$70.00 Select options This product has multiple variants. The options may be chosen on the product pageProgress Notes – w/Vital Signs (Model # IH19-700)
- 500 Progress Notes with Vital Signs Forms/Package
- Includes dedicated section for recording vital signs for up to eight visits
- Columns provided for problem numbers, medications, and re-appointing
- Printed on 60 lb. white book stock in brown ink on both sides
- Two-hole punched on both sides for book style or top and bottom for flip-up style filing
- Size: 8 1/2″ w x 11″ h
$70.00 -
Quick Stick Multi-Purpose Carriers (Model # IH25-7127)
$0.49 Add to cartQuick Stick Multi-Purpose Carriers (Model # IH25-7127)
- 250 Quick Stick Multi-Purpose Carriers/Pack
- Reports are affixed in chronological order from bottom to top or right to left
- Pre-affixed zip tape for quick and easy attachment of reports
- Two-hole punched at the top and side
- Shingles top to bottom
- 13 form capacity
- Salmon bond stock
$0.49 -
Quick-Stick Color Coded Carriers – LAB REPORT CARRIER – 13 Forms Capacity – Buff Bond (Model # IH25-7125)
$122.50 Add to cartQuick-Stick Color Coded Carriers – LAB REPORT CARRIER – 13 Forms Capacity – Buff Bond (Model # IH25-7125)
- 250 Quick-Stick Color Coded Carriers/Pack
- Reports affix in chronological order from bottom to top or right to left
- Pre-affixed zip tape allows quick and easy attachment of reports
- Color-coded and index-tabbed for quick lab reference
- Two-hole punched at the top and side for filing flexibility
- Made of durable buff bond stock
$122.50 -
Quick-Stick Rx Prescription Carriers (Model # IH25-7124)
$122.50 Add to cartQuick-Stick Rx Prescription Carriers (Model # IH25-7124)
- 250 Quick-Stick Rx Prescription Carriers/Package
- 12 form capacity for users of two-part Rx forms
- Duplicate copies affixed in chronological order by shingling from bottom to top
- Zip tape for easy affixing of Rx forms
- Two-hole punched at the top and side
- Goldenrod bond stock
- Size: 8 1/2″ w x 11″ h
$122.50 -
Quick-Stick Telephone Message Carriers (Model # IH25-702)
$0.49 Select options This product has multiple variants. The options may be chosen on the product pageQuick-Stick Telephone Message Carriers (Model # IH25-702)
- 250 Quick-Stick Telephone Message Carriers/Package
- Duplicate message copies affix to carrier in chronological order by shingling from bottom to top
- Pre-affixed zip tape for easy attachment of telephone message forms
- Available in 3 or 7 message capacity options
- Two-hole punched at the top and side for filing flexibility
- Constructed from durable green bond stock
$0.49 -
Rx Prescription Carbon-Back – “Write-It-Once” (Model # IH25-8296)
Read moreRx Prescription Carbon-Back – “Write-It-Once” (Model # IH25-8296)
- 100 Rx Prescription Carbon-Back “Write-It-Once” Pads/Order
- Printed on no-smear, spot carbon paper for automatic duplicate record creation
- Copies each prescription directly onto Progress Notes or Initial Visit Records for permanent documentation
- Helps maintain accurate records of what, when, and why each prescription was written
- Available in single or multiple prescription formats
- Personalized to meet individual practice and state requirements
- For all custom product inquiries and orders, please contact customer service at 1-800-809-5131
-
S.O.A.P. Progress Notes – w/Color Bars (Model # IH26-711)
Price range: $65.00 through $82.50 Select options This product has multiple variants. The options may be chosen on the product pageS.O.A.P. Progress Notes – w/Color Bars (Model # IH26-711)
- 250 S.O.A.P. Progress Notes with Color Bars/Package
- Organized for the SOAP method: Subjective, Objective, Assessment, and Plan
- Flip-up style printed head to foot for easy review of reverse side
- Book style printed head to head to open like a book
- Printed on durable 60 lb. white book stock with color bars for clear section distinction
- Two-hole punched top and bottom for flip-up style or both sides for book style filing
- Size: 8 1/2″ w x 11″ h
Price range: $65.00 through $82.50 -
School Readiness Record (Kindergarten/1st Grade) (Model # IH19-784)
$28.00 Add to cartSchool Readiness Record (Kindergarten/1st Grade) (Model # IH19-784)
- 100 School Readiness Record Forms – Kindergarten/1st Grade/Package
- Summarizes health conditions, immunizations, and provides for a complete physical exam
- Includes age-appropriate questions and tasks to assess school readiness
- Designed for children ages 4–5
- Two-hole punched for side filing
- Size: 8 1/2″ w x 11″ h
$28.00 -
Single and Duplicate Rx Prescription Blanks & Pads (Model # IH25-8292)
Read moreSingle and Duplicate Rx Prescription Blanks & Pads (Model # IH25-8292)
- 100 Single and Duplicate Rx Prescription Blanks and Pads/Order
- Available in horizontal (Style H) or vertical (Style V) format
- Choose from single or duplicate pads or sets to meet your prescription needs
- Personalized with your practice information for professional presentation
- Designed for clear, legible prescription writing and secure record keeping
- For all custom product inquiries and orders, please contact customer service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – California (Model # IH25-8300-CA)
Read moreState Required Security Rx Prescription Blanks & Pads – California (Model # IH25-8300-CA)
- 250 State Required Security Rx Prescription Blanks and Pads – California/Order
- Tamper-resistant prescription blanks and pads compliant with California state law for controlled substances
- Includes thermochromatic ink and advanced anti-fraud security features
- Available in standard formats ranging from 4 1/4″ x 5 1/8″ to 5 1/2″
- Designed with state-mandated layouts and available in laser-compatible formats
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Florida (Model # IH25-8300-FL)
Read moreState Required Security Rx Prescription Blanks & Pads – Florida (Model # IH25-8300-FL)
- 250 State Required Security Rx Prescription Blanks and Pads – Florida/Order
- Complies with Florida Department of Health security requirements for controlled substance prescriptions
- Printed on tamper-resistant stock with all required security features
- Laser-compatible formats available for convenience and accuracy
- Includes checkboxes for “NONACUTE PAIN” and “ACUTE PAIN EXCEPTION” to meet July 1, 2018 compliance standards
- Ensures practitioners adhere to current Florida prescribing regulations
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Indiana (Model # IH25-8300-IN)
Read moreState Required Security Rx Prescription Blanks & Pads – Indiana (Model # IH25-8300-IN)
- 250 State Required Security Rx Prescription Blanks and Pads – Indiana/Order
- Complies with Indiana state requirements for controlled substance prescriptions
- Includes tamper-resistant features for security and fraud prevention
- Usable for both controlled and non-controlled prescriptions within Indiana
- Available in the current “new format” layout for easy, compliant ordering
- Supports use in offices, clinics, and hospitals
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Kentucky (Model # IH25-8300-KY)
Read moreState Required Security Rx Prescription Blanks & Pads – Kentucky (Model # IH25-8300-KY)
- 250 State Required Security Rx Prescription Blanks and Pads – Kentucky/Order
- Complies with Kentucky state requirements for controlled substance prescriptions
- Printed on tamper-resistant stock with security features meeting state standards
- Laser-compatible formats available for EMR and digital prescribing workflows
- Usable for both controlled and non-controlled prescriptions within Kentucky
- Designed for clarity, compliance, and audit readiness
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Maine (Model # IH25-8300-ME)
Read moreState Required Security Rx Prescription Blanks & Pads – Maine (Model # IH25-8300-ME)
- 250 State Required Security Rx Prescription Blanks and Pads – Maine/Order
- Complies with Maine state requirements for controlled substance prescriptions
- Features thermochromatic ink and multiple anti-copy and anti-alteration security elements
- Designed for crisp legibility and reliable pharmacy acceptance
- Available in convenient, office-friendly formats
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – New Jersey (Model # IH25-8300-NJ)
Read moreState Required Security Rx Prescription Blanks & Pads – New Jersey (Model # IH25-8300-NJ)
- 250 State Required Security Rx Prescription Blanks and Pads – New Jersey/Order
- Compliant with New Jersey state requirements for all prescription types
- Available in seven specialty formats to meet diverse prescribing needs
- Includes dedicated “NPI #__________” line; NPI number may be handwritten if not preprinted
- Sequential numbering included for tracking and control
- Custom formats available to meet specific practice or system requirements
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Washington – Medical Marijuana Program (Model # IH25-PRESWALBL-MM-DS)
$63.75 Add to cartState Required Security Rx Prescription Blanks & Pads – Washington – Medical Marijuana Program (Model # IH25-PRESWALBL-MM-DS)
- 5 State Required Security Rx Prescription Pads – Washington – Medical Marijuana Program/Order
- Tamper-resistant paper designed to prevent unauthorized copying, alteration, and forgery of medical marijuana authorization forms
- Approved by the Washington State Pharmacy Board for official use and includes official Washington State Medical Marijuana RCW seal referencing RCW 69.51A.030
- Seal printed in blue (RGB 0, 33, 87; CMYK 100, 92, 34, 35) and placed in the bottom right corner
- Board-approved tamper-resistant paper may be printed in-office
- Authorization paper includes security features such as “Void” pantograph, printed security features on front, watermark on back (“Security Authorization”), or chemical-reactant stain
- Overall size: 8 1/2″ w x 11″ h
- Valid only for Medical Marijuana Authorizations
$63.75 -
State Required Security Rx Prescription Blanks & Pads – Washington (Model # IH25-8300-WA)
Read moreState Required Security Rx Prescription Blanks & Pads – Washington (Model # IH25-8300-WA)
- 250 State Required Security Rx Prescription Blanks and Pads – Washington/Order
- Complies with Washington State requirements for all prescription types
- Includes thermochromatic ink and other state-mandated tamper-resistant security features (effective July 1, 2010)
- Designed to ensure easy pharmacy validation and fraud prevention
- Available in both laser and standard pad formats
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
State Required Security Rx Prescription Blanks & Pads – Wyoming (Model # IH25-8300-WY)
Read moreState Required Security Rx Prescription Blanks & Pads – Wyoming (Model # IH25-8300-WY)
- Wyoming state-mandated security Rx blanks and pads for Level II–V controlled substances
- Effective Jan 1, 2007: thermochromatic ink and other security features; effective July 6, 2011: features listed on both sides, with preprinted quantity boxes and refill instructions
- If not preprinted, prescriber must hand-write quantity and refill instructions in alpha/numeric form (e.g., “Thirty (30) tablets; Two (2) refills”)
- Designed for clear records and regulatory compliance
- For samples or additional information, call Customer Service at 1-800-809-5131
-
Tamper Resistant Rx Prescription Blanks & Pads (Model # IH25-8300-TR)
Read moreTamper Resistant Rx Prescription Blanks & Pads (Model # IH25-8300-TR)
- 250 Tamper Resistant Rx Prescription Blanks and Pads/Order
- Complies with state requirements for controlled substance prescriptions; suitable for all prescription types
- Features multiple security elements including safety paper, void pantograph, security backprinting, reverse Rx, and microprint signature line
- Security features are listed on the back for verification
- Meets Medicaid Security Requirements effective October 1, 2008
- Available in a variety of formats to meet different practice needs
- For assistance or additional information, contact Customer Service at 1-800-809-5131
-
Telephone Record Book with Adhesive Backing (Model # IHB282-200)
$36.20 Add to cartTelephone Record Book with Adhesive Backing (Model # IHB282-200)
- 1 Telephone Record Book/Order (200 messages with duplicate copies)
- Critical messages are clearly documented and retained
- Duplicate copy remains in book as a permanent chronological record
- Original with adhesive backing is filed in patient’s chart
$36.20 -
Veterinary Client Registration (Model # IH58-8413)
$12.00 Add to cartVeterinary Client Registration (Model # IH58-8413)
- 100 Veterinary Client Registration Forms/Package
- Accommodates registration for up to three animals
- Printed on 20 lb. white bond
- Two-hole punched at the top for convenience
- Size: 8 1/2″ w x 5 1/2″ h
$12.00 -
Veterinary Clinical Records & Progress Notes (Model # IH29-8100)
$42.50 Select options This product has multiple variants. The options may be chosen on the product pageVeterinary Clinical Records & Progress Notes (Model # IH29-8100)
- 250 Veterinary Clinical Records and Progress Notes Forms/Package
- Designed to capture comprehensive medical information for accurate patient record keeping
- Printed on both sides for expanded documentation space
- Two-hole punched for secure placement in clinical file folders
- Size: 8 1/2″ w x 11″ h
$42.50
