ComplyRight HIPAA Patient Consent and Authorization Form (A1350)
$54.19
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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"
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ComplyRight HIPAA Patient Consent and Authorization Form (A1350)
Item #: 398021Model #: A1350
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Final price is $54.19
200/pack
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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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Free delivery by Tue, Apr 07
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Unit of measure 100/Box Price per unit $0.20/File Folder
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Compare similar items
| Attributes | ComplyRight HIPAA Patient Consent and Authorization Form (A1350) | Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) | ComplyRight Notice of Privacy Practice, 100/Pack (A1349) | ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) | ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411) |
|---|---|---|---|---|---|
Your product ComplyRight HIPAA Patient Consent and Authorization Form (A1350) Price is $54.19 |  Price is $24.79 |  Price is $19.59 |  Price is $30.19 |  Price is $66.89 | |
| Reviews | |||||
| Delivery Information | Free delivery by Wed, Apr 15 | Delivery by Tue, Apr 07 | Delivery by Wed, Apr 15 | Delivery by Thu, Apr 16 | Free delivery by Tue, Apr 14 |
| Available in my store | No | Yes | No | No | No |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| Length in Inches | 11 | 11 | 11 | 11 | 11 |
| Form Size | 8 1 / 2" x 11" | 8 1 / 2" x 11" | 8 1 / 2" x 11" | Data not available | 8-1 / 2" x 11" |
| True Color | White | White / Red | White | Data not available | White |
| Medical Form Type | Consent | Health Insurance Claims | Privacy Practice | Health Insurance Claims | Dental Claims |
| Medical Form Pack Size | 200 | 100 | 100 | 500 | 1000 |
| Pack Qty | 200 | 100 | 1 | Data not available | Data not available |
| Series or Collection | HIPAA Patient Consent and Authorization Form | CMS-1500 | Data not available | Data not available | Data not available |
| Number of Parts | 1 | 1 | Data not available | Data not available | 1 |
| Print Type | Inkjet / Laser | Data not available | Data not available | Laser | Laser |
| 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 |
