https://www.staples-3p.com/s7/is/image/Staples/s0456534_sc7
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$66.79
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
  • 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
$66.79
200/pack
First time subscribers save 5% off your entire AutoRestock order! Save up to 10% on all following orders. Learn more

Free Returns

Online. In store. Always free.

Learn More

Sign in to unlock exclusive deals and picks just for you. sign in
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
Medical Arts Press Vet Cage Card, Specially Designed for Groomers and Boarding Services, 3 x 5", 250/Pack (20368)~#|#~m002400837_sc7
No reviews yet
Price is $17.89
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
Customers bought together
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)~#|#~s0456534_sc7
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) is Your Product
Price is $66.79
Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~FD6708EB-0D9C-4710-B97EE04BFBA39232_sc7Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~5C934D7B-B3EC-4A1C-AF00C0533240423D_sc7
Price is $19.99
Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~D33F37E0-29DA-4DE1-A60DA5F5135EC483_sc7Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~977ED9C1-4868-495A-9EF8BDABECFAE33D_sc7
Price is $38.09
Staples Glossy 2-Pocket Paper Folder, Light Blue, 10/Pack (13373-CC)~#|#~4A742A39-D1BD-417B-8DAB59CB162A6ECD_sc7Staples Glossy 2-Pocket Paper Folder, Light Blue, 10/Pack (13373-CC)~#|#~5B0E6E98-FEB2-409B-952DFCAAEB1665FC_sc7
Price is $14.09
Price for all 4
$138.96
  • 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) Medical Arts Press Vet Cage Card, Specially Designed for Groomers and Boarding Services, 3 x 5", 250/Pack (20368) ComplyRight™ HIPAA Notice of Privacy Practices Poster (A2123) Cosco Notice of Privacy Practices with Label, English, 8-Part, 250 Forms/Pack (074044) Cosco Notice of Privacy Practices with Label, Spanish, 8-Part, 250 Forms/Pack (074045)
    Your product
    Price is $66.79
    Reviews
    No reviews yet
    No reviews yet
    4.4
    5
    No reviews yet
    No reviews yet
    Delivery Information
    Free delivery by Fri, Dec 26
    Delivery by Thu, Dec 18
    Free delivery by Fri, Dec 26
    Free delivery by Wed, Dec 24
    Free delivery by Wed, Dec 24
    Available in my store
    No
    No
    No
    No
    No
    Length in Inches
    11
    3
    18
    11
    11
    Width in Inches
    8.5
    5
    12
    8.5
    8.5
    Medical Form Type
    Privacy Practice
    Veterinary
    Privacy Practice
    Privacy Practice
    Privacy Practice
    Form Size
    8 1 / 2" x 11"
    Data not available
    12" x 18"
    8.5" x 11"
    8.5" x 11"
    Medical Form Pack Size
    200
    250
    Data not available
    250
    250
    True Color
    White
    Data not available
    White
    Data not available
    Data not available
    Print Type
    Inkjet / Laser
    Continuous
    Data not available
    Laser
    Digital
    Number of Parts
    1
    Data not available
    Data not available
    8
    8
    Pack Qty
    200
    Data not available
    1
    Data not available
    250
    Series or Collection
    Patient Acknowledgment of Receipt
    Data not available
    HIPAA Notice
    Data not available
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    featuredProductsCarouselImage
    featuredProductsCarouselImage