https://www.staples-3p.com/s7/is/image/Staples/s0456534_sc7
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$62.89
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
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)~#|#~s0456534_sc7
Highlights
View all details
  • 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
No reviews yet
Ask a question
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

Only $9.89 Staples Smooth Paper Clips, 1000/pack. Add to cart.
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 Log of Hospital Visits, Pocket-sized, 1-Part~#|#~m002400844_sc7
Price is $18.47
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 $62.89
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
17% off of Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)
Price is $16.99, Regular price was $20.49, You save 17%
Tape Logic 1" Circle "MON" Days of the Week Label, Fluorescent Yellow, 500/Roll~#|#~sp127287630_sc7Tape Logic 1" Circle "MON" Days of the Week Label, Fluorescent Yellow, 500/Roll~#|#~s0708061_sc7
Price is $35.79
Staples 2-Pocket Plastic Presentation Folder, Clear (ST26382-CC)~#|#~E009AD03-CB80-46F3-A5BB6E0885BEB73F_sc7Staples 2-Pocket Plastic Presentation Folder, Clear (ST26382-CC)~#|#~A1C9656B-8FC0-416B-9236D3A01AEF4DFC_sc7
Price is $2.49
Price for all 4
$118.16
    • Details

    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

    Frequently bought together

    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
    17% off of Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)
    Price is $16.99, Regular price was $20.49, You save 17%
    Unit of measure 100/Box Price per unit $0.17/File Folder
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Sharpie Permanent Marker, Fine Tip, Black, 12/Pack (30001)~#|#~sp161466825_sc7Sharpie Permanent Marker, Fine Tip, Black, 12/Pack (30001)~#|#~6064CE3F-ACD3-4B27-A2D57D95E89CA0DE_sc7
    19% off of Sharpie Permanent Marker, Fine Tip, Black, 12/Pack (30001)
    Price is $9.99, Regular price was $12.39, You save 19%
    Unit of measure Dozen Price per unit $0.83/Marker
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Post-it Notes, 3" x 3", Canary Collection, 100 Sheet/Pad, 12 Pads/Pack (654-12YW)~#|#~EC8283BA-EE0A-4C60-92938D6E89BA29D9_sc7Post-it Notes, 3" x 3", Canary Collection, 100 Sheet/Pad, 12 Pads/Pack (654-12YW)~#|#~54AEF998-2DD5-4EFA-B6CC8AA271777255_sc7
    8% off of Post-it Notes, 3" x 3", Canary Collection, 100 Sheet/Pad, 12 Pads/Pack (654-12YW)
    Price is $13.99, Regular price was $15.29, You save 8%
    Unit of measure Dozen Price per unit $0.01/Post-it® Note
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    BIC Wite-Out EZ Correct Correction Tape, White, 10/Pack (WOTAP10)~#|#~37145111-61CC-4778-8BA9E87A15E9782E_sc7BIC Wite-Out EZ Correct Correction Tape, White, 10/Pack (WOTAP10)~#|#~8E43A97B-9DA0-4CA2-902D89E2DEA6B770_sc7
    Price is $19.49
    Unit of measure 10/Pack Price per unit $1.95/Correction Tape
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Notepads, 8.5" x 11.75", Wide Ruled, White, 50 Sheets/Pad, Dozen (ST57339M/57339)~#|#~s1212509_sc7Staples Notepads, 8.5" x 11.75", Wide Ruled, White, 50 Sheets/Pad, Dozen (ST57339M/57339)~#|#~51038708-2CBE-4495-8D10AD8D905CB9E1_sc7
    13% off of Staples Notepads, 8.5" x 11.75", Wide Ruled, White, 50 Sheets/Pad, Dozen (ST57339M/57339)
    Price is $16.99, Regular price was $19.59, You save 13%
    Unit of measure Dozen Price per unit $1.42/Pad
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Smooth Paper Clips, Silver, 100 Clips/Pack, 10/Pack(A7026607/72377)~#|#~2C8E80BB-F88F-4271-AC08B3B70FFEDD08_sc7Staples Smooth Paper Clips, Silver, 100 Clips/Pack, 10/Pack(A7026607/72377)~#|#~ACB66921-CE6F-4799-B5D9C1DA60D0E5AA_sc7
    Price is $10.19
    Unit of measure 1000/Pack Price per unit $0.01/Paper Clip
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    BIC Round Stic Xtra-Life Ballpoint Pen, Medium Point, 1.0mm, Black Ink, 60/Pack (GSM609-BLK)~#|#~F14E33B0-6760-4445-931173C7A61A8896_sc7BIC Round Stic Xtra-Life Ballpoint Pen, Medium Point, 1.0mm, Black Ink, 60/Pack (GSM609-BLK)~#|#~AFD5FBB8-71A3-434C-989B74986834C3E5_sc7
    Price is $8.69
    Unit of measure 60/Pack Price per unit $0.14/Pen
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    BIC Wite-Out Correction Tape, White, 4/Pack (50589)~#|#~F7B223E8-9DBF-48AF-82A0DB71375F554F_sc7BIC Wite-Out Correction Tape, White, 4/Pack (50589)~#|#~52CEA232-31BF-463C-901C222C3FEA84B4_sc7
    Price is $8.19
    Unit of measure 4/Pack Price per unit $2.05/Correction Tape
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 250/Box (ST56673-CC)~#|#~0BCB0B2E-F722-4F55-974EF7E0F739293A_sc7Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 250/Box (ST56673-CC)~#|#~685E0358-7F19-4822-8885CC6495C67ECF_sc7
    9% off of Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 250/Box (ST56673-CC)
    Price is $27.99, Regular price was $30.79, You save 9%
    Unit of measure 250/Box Price per unit $0.11/File Folder
    Next-Day Delivery by tomorrow
    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
    Staples Small Binder Clips, 0.38" Capacity, Black, 144 Clips/Pack (ST32002/32002)~#|#~s1215135_sc7Staples Small Binder Clips, 0.38" Capacity, Black, 144 Clips/Pack (ST32002/32002)~#|#~303AD32B-CAD9-4E2D-99A71E1DB00A5D0E_sc7
    Price is $10.59
    Unit of measure 144/Pack Price per unit $0.07/Binder Clip
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Large Binder Clips, 1" Capacity, Black, 12 Clips/Pack (10669-CC)~#|#~s1215160_sc7Staples Large Binder Clips, 1" Capacity, Black, 12 Clips/Pack (10669-CC)~#|#~38CE1B7B-BD60-4CFD-B548856BB33DE8A8_sc7
    Price is $8.19
    Unit of measure 12/Pack Price per unit $0.68/Binder Clip
    Next-Day Delivery by tomorrow
    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
    Scotch Magic Invisible Clear Tape Refill, 0.75" x 27.77 yds., 1" Core, Invisible, 10 Rolls/Pack (810P10K)~#|#~47D65176-0F54-43CB-A1235DC05CE49BDF_sc7Scotch Magic Invisible Clear Tape Refill, 0.75" x 27.77 yds., 1" Core, Invisible, 10 Rolls/Pack (810P10K)~#|#~1BCE2F28-D030-446B-B89DB7AC97C4151A_sc7
    15% off of Scotch Magic Invisible Clear Tape Refill, 0.75" x 27.77 yds., 1" Core, Invisible, 10 Rolls/Pack (810P10K)
    Price is $16.99, Regular price was $19.99, You save 15%
    Unit of measure 10/Pack Price per unit $1.70/Roll
    Next-Day Delivery by tomorrow
    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
    Pilot G2 Retractable Gel Pens, Fine Point, 0.7mm, Black Ink, Dozen (31020)~#|#~sp40286009_sc7Pilot G2 Retractable Gel Pens, Fine Point, 0.7mm, Black Ink, Dozen (31020)~#|#~sp130855922_sc7
    Price is $20.49
    Unit of measure Dozen Price per unit $1.71/Pen
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Medium Binder Clips, 0.63" Capacity, Black, 24 Clips/Pack (ST10668/10668)~#|#~s1215159_sc7Staples Medium Binder Clips, 0.63" Capacity, Black, 24 Clips/Pack (ST10668/10668)~#|#~62B5B13B-88C6-4519-82FF776C4B032D2A_sc7
    Price is $7.19
    Unit of measure 24/Pack Price per unit $0.30/Binder Clip
    Next-Day Delivery by tomorrow
    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
    Staples 65% Recycled Corrugated File Box Lift Off Lid, Letter/Legal Size, White/Black, 10/Pack (23325011)~#|#~s1219817_sc7Staples 65% Recycled Corrugated File Box Lift Off Lid, Letter/Legal Size, White/Black, 10/Pack (23325011)~#|#~664B5F7F-2C7B-444D-926EFC3F11480459_sc7
    Price is $30.79
    Unit of measure 10/Pack Price per unit $3.08/Box
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Notepads, 5" x 8", Narrow Ruled, White, 50 Sheets/Pad, Dozen (ST57338)~#|#~s1212081_sc7Staples Notepads, 5" x 8", Narrow Ruled, White, 50 Sheets/Pad, Dozen (ST57338)~#|#~E8EB58A6-1FCF-4A53-9DABEFD0F20E751E_sc7
    16% off of Staples Notepads, 5" x 8", Narrow Ruled, White, 50 Sheets/Pad, Dozen (ST57338)
    Price is $9.99, Regular price was $11.99, You save 16%
    Unit of measure 12/Pack Price per unit $0.83/Pad
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples® Invisible Clear Tape, 0.75" x 36 yds., 1" Core, Transparent, 12 Rolls/Pack (52477-P12)~#|#~2C901AE5-D384-425C-AAD04863A9579659_sc7Staples® Invisible Clear Tape, 0.75" x 36 yds., 1" Core, Transparent, 12 Rolls/Pack (52477-P12)~#|#~A77A6F8D-28F4-4AC5-B4748BE1B8D373E0_sc7
    Price is $18.29
    Unit of measure 12/Pack Price per unit $1.52/Roll
    Next-Day Delivery by tomorrow
    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
    Sharpie Permanent Marker, Fine Tip, Black, 36/Pack (1884739)~#|#~1BCDF1C0-5454-4A4A-A616BD9601C8C140_sc7Sharpie Permanent Marker, Fine Tip, Black, 36/Pack (1884739)~#|#~D67EC31B-0DB3-45F9-BD62DC872D1ACBF1_sc7
    2% off of Sharpie Permanent Marker, Fine Tip, Black, 36/Pack (1884739)
    Price is $28.69, Regular price was $29.49, You save 2%
    Unit of measure 36/Pack Price per unit $0.80/Marker
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Jumbo Paper Clips, Silver, 1000 Clips/Pack, 10/Pack(A7026606/72577)~#|#~529131DF-60CE-4793-9DD3915B0C5ED14D_sc7Staples Jumbo Paper Clips, Silver, 1000 Clips/Pack, 10/Pack(A7026606/72577)~#|#~58A18485-A587-4C09-B4F919911EAB4F75_sc7
    Price is $16.89
    Unit of measure 1000/Pack Price per unit $0.02/Paper Clip
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Staples Recycled Notes, 3" x 3", Sunshine Collection, 100 Sheet/Pad, 18 Pads/Pack (S-33YR18/52569)~#|#~010DFD1E-E98D-41F5-81AB0FC2144F0118_sc7Staples Recycled Notes, 3" x 3", Sunshine Collection, 100 Sheet/Pad, 18 Pads/Pack (S-33YR18/52569)~#|#~35E9AD06-827F-4D40-AB6F7EFA28130B0D_sc7
    33% off of Staples Recycled Notes, 3" x 3", Sunshine Collection, 100 Sheet/Pad, 18 Pads/Pack (S-33YR18/52569)
    Price is $7.99, Regular price was $11.99, You save 33%
    Unit of measure 18/Pack
    Next-Day Delivery by tomorrow
    1-hr pickup
    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
    Specifications
    Specifications table
    Attribute nameAttribute value
    Length in Inches 11
    Medical Form Type Privacy Practice
    Number of Parts 1
    Form Size
    		8 1/2" x 11"
    Medical Form Pack Size 200
    Pack Qty 200
    Width in Inches
    		8.5
    Series or Collection
    		Patient Acknowledgment of Receipt
    True Color
    		White
    Print Type Inkjet/Laser
    Reviews

    Reviews

    There are no reviews yet. Be the first to write one!

    Compare similar items

     
    Your product
    ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
    Price is $62.89

    Compare similar items

     
    Product specifications table
    Attributes ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Medical Arts Press Log of Hospital Visits, Pocket-sized, 1-Part ComplyRight Notice of Privacy Practice, 100/Pack (A1349) ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211) ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500) ComplyRight™ Expanded Confidential Employee Medical Records Folder, Pack of 25 (A3325) ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100) ComplyRight Employee Benefits & Insurance Records Organizer, Pack of 25 (A0309) ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241) ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411) ComplyRight™ HIPAA Notice of Privacy Practices Poster (A2123) ComplyRight 1-Part Confidential Employee Record Folder, 25/Pack (A0503) ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250) ComplyRight Employee Warning Notice, Pack of 50 (A2311) ComplyRight Orthodontic Case Analysis File, 9.5" x 11.75", 25 Folders/Pack (A1048)
    Your product
    ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
    Price is $62.89
    Medical Arts Press Log of Hospital Visits, Pocket-sized, 1-Part~#|#~m002400844_sc7
    Price is $18.47
    ComplyRight Notice of Privacy Practice, 100/Pack (A1349)
    Price is $36.79
    ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211)
    Price is $144.69
    ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)~#|#~8C5CF2B1-C564-4834-B70E58035F19DEAC_sc7
    Price is $40.99
    ComplyRight™ Expanded Confidential Employee Medical Records Folder, Pack of 25 (A3325)
    Price is $147.19
    ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)~#|#~652ADB45-0A5E-495C-B7A6ABBF7660E69C_sc7
    Price is $15.79
    ComplyRight Employee Benefits & Insurance Records Organizer, Pack of 25 (A0309)
    Price is $77.89
    ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)~#|#~30211E02-A935-406B-A6832AFD0B88E088_sc7
    Price is $125.99
    ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)~#|#~BEEB25B0-3006-416D-A7EB845F6AB6205B_sc7
    Price is $27.59
    ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)~#|#~4A9BEC59-372C-4BA2-98230C384214A03F_sc7
    Price is $62.99
    ComplyRight™ HIPAA Notice of Privacy Practices Poster (A2123)
    Price is $33.19
    ComplyRight 1-Part Confidential Employee Record Folder, 25/Pack (A0503)~#|#~sp42718361_sc7
    Price is $110.49
    ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
    Price is $32.09
    ComplyRight Employee Warning Notice, Pack of 50 (A2311)
    Price is $65.09
    ComplyRight Orthodontic Case Analysis File, 9.5" x 11.75", 25 Folders/Pack (A1048)
    Price is $74.13
    Reviews
    No reviews yet
    3.5
    4
    No reviews yet
    4
    1
    No reviews yet
    1
    1
    No reviews yet
    No reviews yet
    No reviews yet
    No reviews yet
    No reviews yet
    4.4
    5
    4.6
    5
    4.8
    19
    No reviews yet
    No reviews yet
    Delivery Information
    Free delivery by Mon, May 05
    Delivery by Tue, Apr 29
    Free delivery by Mon, May 05
    Free delivery by Mon, May 05
    Free delivery by Fri, May 02
    Free delivery by Mon, May 05
    Delivery by Fri, May 02
    Free delivery by Mon, May 05
    Free delivery by Fri, May 02
    Delivery by Tue, May 06
    Free delivery by Fri, May 02
    Delivery by Mon, May 05
    Free delivery by Mon, May 05
    Next-Day Delivery by tomorrow
    Free delivery by Mon, May 05
    Free delivery by Mon, May 05
    Available in my store
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    Width in Inches
    8.5
    5.75
    8.5
    9.375
    8.5
    9
    8.5
    9.5
    8.5
    8.5
    8.5
    12
    11.5
    8.5
    8.5
    11.75
    Length in Inches
    11
    3.375
    11
    11.75
    11
    11
    11
    11.75
    11
    11
    11
    18
    Data not available
    11
    11
    9.5
    Form Size
    8 1 / 2" x 11"
    5 3 / 4" x 3 3 / 8"
    8 1 / 2" x 11"
    9.375" x 11.75"
    8-1 / 2" x 11"
    9" x 11"
    8-1 / 2" X 11"
    11.75" x 9.5"
    8-1 / 2" x 11"
    Data not available
    8-1 / 2" x 11"
    12" x 18"
    Data not available
    8 1 / 2" x 11"
    8 1 / 2" x 11"
    9.5" x 11.75"
    Medical Form Type
    Privacy Practice
    Data not available
    Privacy Practice
    Medical Records Folders
    Dental Claims
    Medical Records Folders
    Dental Claims
    Data not available
    Dental Claims
    Health Insurance Claims
    Dental Claims
    Privacy Practice
    Medical Records Folders
    Health Insurance Claims
    Data not available
    Data not available
    True Color
    White
    Data not available
    White
    Data not available
    White
    Data not available
    White
    Manila
    White
    Data not available
    White
    White
    White / Blue
    White
    White
    Beige
    Medical Form Pack Size
    200
    Data not available
    100
    25
    500
    25
    100
    Data not available
    2500
    500
    1000
    Data not available
    25
    250
    Data not available
    Data not available
    Pack Qty
    200
    Data not available
    1
    1
    Data not available
    1
    Data not available
    1
    Data not available
    Data not available
    Data not available
    1
    25
    Data not available
    1
    1
    Print Type
    Inkjet / Laser
    Data not available
    Data not available
    Data not available
    Laser
    Data not available
    Laser
    Data not available
    Laser
    Laser
    Laser
    Data not available
    Inkjet / Laser
    Laser
    Data not available
    Data not available
    Number of Parts
    1
    1
    Data not available
    Data not available
    1
    Data not available
    1
    Data not available
    1
    Data not available
    1
    Data not available
    1
    Data not available
    Data not available
    Data not available
    Series or Collection
    Patient Acknowledgment of Receipt
    Log of Hospital Visits
    Data not available
    ComplyRight
    Data not available
    ComplyRight
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    HIPAA Notice
    Data not available
    CMS-1500
    Employee Warning Notice
    Data not available
    Price Per Unit
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    $4.42 / File Folder
    Data not available
    Data not available
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart

    Featured Products