ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$66.79
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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
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Final price is $66.79
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
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Your product ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Price is $66.79 |  Price is $56.39 |  Price is $35.29 |  Price is $199.99 |  Price is $199.99 | |
| Reviews | |||||
| Delivery Information | Free delivery by Thu, Dec 11 | Free delivery by Tue, Dec 02 | Free delivery by Thu, Dec 11 | Free delivery by Wed, Dec 10 | Free delivery by Wed, Dec 10 |
| Available in my store | No | No | No | No | No |
| Length in Inches | 11 | 3.375 | 18 | 11 | 11 |
| Width in Inches | 8.5 | 5.75 | 12 | 8.5 | 8.5 |
| Form Size | 8 1 / 2" x 11" | 5 3 / 4" x 3 3 / 8" | 12" x 18" | 8.5" x 11" | 8.5" x 11" |
| Medical Form Type | Privacy Practice | Data not available | Privacy Practice | Privacy Practice | Privacy Practice |
| Medical Form Pack Size | 200 | Data not available | Data not available | 250 | 250 |
| True Color | White | Data not available | White | Data not available | Data not available |
| Number of Parts | 1 | 1 | Data not available | 8 | 8 |
| Print Type | Inkjet / Laser | Data not available | Data not available | Laser | Digital |
| Pack Qty | 200 | Data not available | 1 | Data not available | 250 |
| Series or Collection | Patient Acknowledgment of Receipt | Log of Hospital Visits | HIPAA Notice | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
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