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ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$45.39
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  • Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
  • HIPAA compliant
  • Size: 8 1/2" x 11"
MADE IN AMERICA

ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)

Item #: 398026Model #: A1354
$45.39
200/pack
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  • About this product

    ComplyRight Patient acknowledgment of receipt of privacy practices notice measures 8 1/2" x 11".

    ComplyRight Patient acknowledgment of receipt of privacy practices notice is attorney approved form acknowledging patient's information to be released to an authorized third party. Notice measures 8 1/2" x 11".

    • Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
    • HIPAA compliant
    • Size: 8 1/2" x 11"
    • Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
    • HIPAA compliant

    Compare similar items

    Product specifications table
    Attributes ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500) ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211) ComplyRight Employee Benefits & Insurance Records Organizer, Pack of 25 (A0309) ComplyRight™ Expanded Confidential Employee Medical Records Folder, Pack of 25 (A3325)
    Your product
    Price is $45.39
    Reviews
    No reviews yet
    No reviews yet
    No reviews yet
    Delivery Information
    Free delivery by Tue, Jun 30
    Free delivery by Fri, Jun 26
    Free delivery by Tue, Jun 30
    Free delivery by Tue, Jun 30
    Free delivery by Tue, Jun 30
    Available in my store
    No
    No
    No
    No
    No
    Length in Inches
    11
    11
    11.75
    11.75
    11
    Form Size
    8 1 / 2" x 11"
    8-1 / 2" x 11"
    9.375" x 11.75"
    11.75" x 9.5"
    9" x 11"
    Width in Inches
    8.5
    8.5
    9.375
    9.5
    9
    Pack Qty
    200
    Data not available
    1
    1
    1
    Medical Form Type
    Privacy Practice
    Dental Claims
    Medical Records Folders
    Data not available
    Medical Records Folders
    True Color
    White
    White
    Data not available
    Manila
    Data not available
    Medical Form Pack Size
    200
    500
    25
    Data not available
    25
    Series or Collection
    Patient Acknowledgment of Receipt
    Data not available
    ComplyRight
    Data not available
    ComplyRight
    Number of Parts
    1
    1
    Data not available
    Data not available
    Data not available
    Print Type
    Inkjet / Laser
    Laser
    Data not available
    Data not available
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
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