ComplyRight HIPAA Patient Consent and Authorization Form (A1350)
$54.19
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Highlights
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- Attorney approved form acknowledging patient's consent to release his or her protected health information to an authorized third party
- Complies with HIPAA’s authorization requirements
- Size: 8 1/2" x 11"
MADE IN AMERICA
ComplyRight HIPAA Patient Consent and Authorization Form (A1350)
Item #: 398021Model #: A1350
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$54.19
200/pack
Free Returns
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About this product
ComplyRight Patient consent and authorization form measures 8 1/2" x 11".
ComplyRight Patient consent and authorization form is attorney approved form acknowledging patient's information to be released to an authorized third party. Form measures 8 1/2" x 11".
- Attorney approved form acknowledging patient's consent to release his or her protected health information to an authorized third party
- Complies with HIPAA’s authorization requirements
- Size: 8 1/2" x 11"
- Attorney approved form acknowledging patient's consent to release his or her protected health information to an authorized third party
- Complies with HIPAAs authorization requirements
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Unit of measure 5000/Carton
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Compare similar items
| Attributes | ComplyRight HIPAA Patient Consent and Authorization Form (A1350) | Cosco Notice of Privacy Practices with Label, English, 8-Part, 250 Forms/Pack (074044) | Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) | ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) | ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241) |
|---|---|---|---|---|---|
Your product ComplyRight HIPAA Patient Consent and Authorization Form (A1350) Price is $54.19 |  Price is $152.59 |  Price is $24.79 |  Price is $29.39 |  Price is $133.69 | |
| Reviews | |||||
| Delivery Information | Free delivery by Thu, Apr 02 | Free delivery by Thu, Apr 02 | Delivery by Wed, Mar 25 | Delivery by Fri, Apr 03 | Free delivery by Tue, Mar 31 |
| Available in my store | No | No | Yes | No | No |
| Length in Inches | 11 | 11 | 11 | 11 | 11 |
| Form Size | 8.5" x 11" | 8.5" x 11" | 8 1 / 2" x 11" | Data not available | 8-1 / 2" x 11" |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| Medical Form Type | Privacy Practice | Privacy Practice | Health Insurance Claims | Health Insurance Claims | Dental Claims |
| Medical Form Pack Size | 250 | 250 | 100 | 500 | 2500 |
| True Color | Data not available | Data not available | White / Red | Data not available | White |
| Pack Qty | Data not available | Data not available | 100 | Data not available | Data not available |
| Print Type | Laser | Laser | Data not available | Laser | Laser |
| Series or Collection | Data not available | Data not available | CMS-1500 | Data not available | Data not available |
| Number of Parts | 8 | 8 | 1 | Data not available | 1 |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
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Price is $81.69
Unit of measure 500/Box
Free delivery by Mon, Mar 30
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Unit of measure 250/Box
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Delivery by Mon, Mar 30
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Delivery by Thu, Apr 02
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