ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$39.89
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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"
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #: 398026Model #: A1354
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$39.89
200/pack
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Price is $19.59
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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
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Price is $149.99, Regular price was $329.99, You save 54%
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Next-Day Delivery by tomorrow
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Price is $179.99, Regular price was $299.99, You save 40%
Free Next-Day eligible by tomorrow
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Compare similar items
| Attributes | ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) | ComplyRight Notice of Privacy Practice, 100/Pack (A1349) | 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) |
|---|---|---|---|---|---|
Your product ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Price is $39.89 |  Price is $19.59 |  Price is $30.19 |  Price is $101.39 |  Price is $66.89 | |
| Reviews | |||||
| Delivery Information | Free delivery by Tue, Sep 15 | Delivery by Tue, Sep 15 | Delivery by Wed, Sep 16 | Free delivery by Tue, Sep 15 | Free delivery by Fri, Sep 11 |
| Available in my store | No | No | No | No | No |
| Width in Inches | 8.5 | 8.5 | 8.5 | 9.375 | 8.5 |
| Length in Inches | 11 | 11 | 11 | 11.75 | 11 |
| Form Size | 8 1 / 2" x 11" | 8 1 / 2" x 11" | Data not available | 9.375" x 11.75" | 8-1 / 2" x 11" |
| Medical Form Type | Privacy Practice | Privacy Practice | Health Insurance Claims | Medical Records Folders | Dental Claims |
| Medical Form Pack Size | 200 | 100 | 500 | 25 | 1000 |
| Pack Qty | 200 | 1 | Data not available | 1 | Data not available |
| True Color | White | White | Data not available | Data not available | White |
| Print Type | Inkjet / Laser | Data not available | Laser | Data not available | Laser |
| Number of Parts | 1 | Data not available | Data not available | Data not available | 1 |
| Series or Collection | Patient Acknowledgment of Receipt | Data not available | Data not available | ComplyRight | 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 |