ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$45.39
1
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"
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #: 398026Model #: A1354
No reviews yet
$45.39
200/pack
Free Returns
Online. In store. Always free.
Learn More
1
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
Add to list
No reviews yet
Price is $19.59
1
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
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
Page 1 of 4
Price is $259.99, Regular price was $429.99, You save 39%
Free Next-Day eligible by tomorrow
1
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
Add to list
Price is $169.99, Regular price was $329.99, You save 48%
Free Next-Day eligible by tomorrow
30-min pickup
1
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
Add to list
Price is $16.99, Regular price was $27.19, You save 37%
Unit of measure 1500/Carton
Next-Day Delivery by tomorrow
30-min pickup
1
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
Add to list
Price is $18.49
Delivery by Mon, Jul 27
1
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
Add to list
Price is $42.99, Regular price was $71.59, You save 39%
Unit of measure 4000/Carton
Free Next-Day eligible by tomorrow
1
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
Add to list
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 Employee Benefits & Insurance Records Organizer, Pack of 25 (A0309) |
|---|---|---|---|---|---|
Your product ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Price is $45.39 |  Price is $19.59 |  Price is $30.19 |  Price is $101.39 |  Price is $101.39 | |
| Reviews | |||||
| Delivery Information | Free delivery by Fri, Jul 24 | Delivery by Fri, Jul 24 | Delivery by Mon, Jul 27 | Free delivery by Fri, Jul 24 | Free delivery by Fri, Jul 24 |
| Available in my store | No | No | No | No | No |
| Length in Inches | 11 | 11 | 11 | 11.75 | 11.75 |
| Width in Inches | 8.5 | 8.5 | 8.5 | 9.375 | 9.5 |
| Form Size | 8 1 / 2" x 11" | 8 1 / 2" x 11" | Data not available | 9.375" x 11.75" | 11.75" x 9.5" |
| Medical Form Type | Privacy Practice | Privacy Practice | Health Insurance Claims | Medical Records Folders | Data not available |
| Medical Form Pack Size | 200 | 100 | 500 | 25 | Data not available |
| Pack Qty | 200 | 1 | Data not available | 1 | 1 |
| True Color | White | White | Data not available | Data not available | Manila |
| Series or Collection | Patient Acknowledgment of Receipt | Data not available | Data not available | ComplyRight | Data not available |
| Print Type | Inkjet / Laser | Data not available | Laser | Data not available | Data not available |
| Number of Parts | 1 | Data not available | Data not available | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Page 1 of 3
Price is $49.59
Unit of measure 250/Box
Free delivery by Wed, Jul 22
1
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
Add to list
Price is $14.39
Unit of measure 50/Pack
Delivery by Wed, Jul 22
1
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
Add to list
Price is $81.69
Unit of measure 500/Box
Free delivery by Wed, Jul 22
1
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
Add to list
Price is $65.39
Unit of measure 500/Ream
Free delivery by Wed, Jul 22
1
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
Add to list
Price is $15.09
Unit of measure 50/Pack
Delivery by Wed, Jul 22
1
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
Add to list
