ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$39.89
Highlights
View all details
- 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"
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #: 398026Model #: A1354
No reviews yet
$39.89
200/pack
Free Returns
Online. In store. Always free.
Learn More
Add to list
Consider this alternative
Page 1 of 1
No reviews yet
Price is $19.59
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
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
Frequently bought together
Page 1 of 4
Price is $18.49
Unit of measure 100/Box Price per unit $0.18/File Folder
Delivery by Tue, Oct 20
30-min pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $169.99, Regular price was $329.99, You save 48%
Free delivery by Tue, Oct 20
30-min pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $59.99, Regular price was $129.99, You save 54%
Free delivery by Tue, Oct 20
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
NeeDoh Dream Drop, Color Chosen at Random (DRDND) is In-store only
Price is $6.29
Add to list
Price is $49.99, Regular price was $89.99, You save 44%
Free delivery by Tue, Oct 20
30-min pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Compare similar items
| Attributes | ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) | ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) | ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211) | ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411) | ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241) |
|---|---|---|---|---|---|
Your product ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Price is $39.89 Out of Stock |  Price is $30.19 |  Price is $101.39 |  Price is $66.89 |  Price is $133.69 | |
| Reviews | |||||
| Delivery Information | Data not available | Delivery by Thu, Oct 29 | Free delivery by Wed, Oct 28 | Free delivery by Mon, Oct 26 | Free delivery by Mon, Oct 26 |
| Available in my store | No | No | No | No | No |
| Width in Inches | 8.5 | 8.5 | 9.375 | 8.5 | 8.5 |
| Length in Inches | 11 | 11 | 11.75 | 11 | 11 |
| Form Size | 8 1 / 2" x 11" | Data not available | 9.375" x 11.75" | 8-1 / 2" x 11" | 8-1 / 2" x 11" |
| Medical Form Type | Privacy Practice | Health Insurance Claims | Medical Records Folders | Dental Claims | Dental Claims |
| Medical Form Pack Size | 200 | 500 | 25 | 1000 | 2500 |
| Pack Qty | 200 | Data not available | 1 | Data not available | Data not available |
| True Color | White | Data not available | Data not available | White | White |
| Print Type | Inkjet / Laser | Laser | Data not available | Laser | Laser |
| Number of Parts | 1 | Data not available | Data not available | 1 | 1 |
| Series or Collection | Patient Acknowledgment of Receipt | Data not available | ComplyRight | Data not available | Data not available |
| Price Per Unit | Data not available | Data not available | Data not available | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Page 1 of 3
Price is $81.69
Unit of measure 500/Box
Free delivery by Fri, Oct 23
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $15.99
Unit of measure 10/Pack
Delivery by Fri, Oct 23
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $20.19
Delivery by Wed, Oct 28
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $17.95
Delivery by Wed, Oct 28
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
Price is $60.99
Unit of measure 25/Pack
Free delivery by Fri, Oct 23
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Add to list
