Physical 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
Additional information
| Weight | 1.125 lbs |
|---|
Related products
-
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 -
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 -
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 -
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
