Highlights
View all details
- 250 sets per pack
- 8-part form
- Removable label for patient's folder
MADE IN AMERICA
New at Staples
Cosco Notice of Privacy Practices with Label, English, 8-Part, 250 Forms/Pack (074045)
Item #: 24643944Model #: 074045
No reviews yet
Final price is $362.99
Free Returns
Online. In store. Always free.
Learn More
About this product
Written Notice of Privacy Practices must be provided to patients on or before the first encounter and to other persons on request. The Notice notifies the patient of all uses and disclosures of his or her protected health information and outlines all the legal duties of the practice.
Form is over seven pages, completely comprehensive and includes all of the key elements required by HIPAA and more! The form also contains a removable label which provides practices with a written acknowledgement that the patient received the Privacy Notice (as required to be HIPAA compliant). No need for practice to make copies and file additional paperwork, simply place the label onto the patient folder. Form is also available in Spanish.
- 250 sets per pack
- 8-part form
- Removable label for patient's folder
Frequently bought together
Price is $16.99, Regular price was $20.59, You save 17%
Unit of measure 100/Box Price per unit $0.17/File Folder
Delivery by Tue, Jun 10
1-hr 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
Price is $10.59, Regular price was $12.69, You save 16%
Unit of measure Dozen Price per unit $0.88/Marker
Delivery by Tue, Jun 10
1-hr 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
Price is $15.69
Unit of measure Dozen Price per unit $0.01/Post-it® Note
Delivery by Tue, Jun 10
1-hr 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
Price is $16.99, Regular price was $19.59, You save 13%
Unit of measure Dozen Price per unit $1.42/Pad
Delivery by Tue, Jun 10
1-hr 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
Price is $19.49
Unit of measure 10/Pack Price per unit $1.95/Correction Tape
Delivery by Tue, Jun 10
1-hr 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
Price is $8.69
Unit of measure 60/Pack Price per unit $0.14/Pen
Delivery by Tue, Jun 10
1-hr 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
Price is $9.99
Unit of measure 1000/Pack Price per unit $0.01/Paper Clip
Delivery by Tue, Jun 10
1-hr 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
Price is $8.19
Unit of measure 4/Pack Price per unit $2.05/Correction Tape
Delivery by Tue, Jun 10
1-hr 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
Price is $27.99, Regular price was $31.69, You save 11%
Unit of measure 250/Box Price per unit $0.11/File Folder
Delivery by Tue, Jun 10
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
Price is $9.99, Regular price was $11.99, You save 16%
Unit of measure 12/Pack Price per unit $0.83/Pad
Delivery by Tue, Jun 10
1-hr 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
Price is $20.49
Unit of measure Dozen Price per unit $1.71/Pen
Delivery by Tue, Jun 10
1-hr 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
Price is $13.99
Unit of measure 144/Pack Price per unit $0.10/Binder Clip
Delivery by Tue, Jun 10
1-hr 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
Price is $8.69
Unit of measure 12/Pack Price per unit $0.72/Binder Clip
Delivery by Tue, Jun 10
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
Price is $18.29
Unit of measure 12/Pack Price per unit $1.52/Roll
Delivery by Tue, Jun 10
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
Price is $7.59
Unit of measure 24/Pack Price per unit $0.32/Binder Clip
Delivery by Tue, Jun 10
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
Price is $16.99, Regular price was $19.59, You save 13%
Unit of measure Dozen Price per unit $1.42/Pad
Delivery by Tue, Jun 10
1-hr 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
Price is $17.89
Unit of measure 1000/Pack Price per unit $0.02/Paper Clip
Delivery by Tue, Jun 10
1-hr 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
Price is $25.99, Regular price was $29.49, You save 11%
Unit of measure 36/Pack Price per unit $0.72/Marker
Delivery by Tue, Jun 10
1-hr 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
Price is $20.49
Unit of measure 10/Pack Price per unit $2.05/Roll
Delivery by Tue, Jun 10
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
Price is $30.79
Unit of measure 10/Pack Price per unit $3.08/Box
Delivery by Tue, Jun 10
1-hr 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
Compare similar items
| Attributes | Cosco Notice of Privacy Practices with Label, English, 8-Part, 250 Forms/Pack (074045) | Cosco Privacy Sign-In Sheets, 3-Part, 125 Forms/Pack (074040) | Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074041) | Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074043) | Cosco Patient Confidential Sign-In Forms, 3-Part, 125 Forms/Pack (074039) |
|---|---|---|---|---|---|
Your product Cosco Notice of Privacy Practices with Label, English, 8-Part, 250 Forms/Pack (074045) Price is $362.99 Out of Stock |  Price is $58.29 |  Price is $58.29 |  Price is $58.29 |  Price is $58.29 | |
| Reviews | |||||
| Delivery Information | Data not available | Free delivery by Wed, Jun 18 | Free delivery by Wed, Jun 18 | Free delivery by Wed, Jun 18 | Free delivery by Wed, Jun 18 |
| Available in my store | No | No | No | No | No |
| Length in Inches | 11 | 11.625 | 11.625 | 11.624 | 11.625 |
| Medical Form Type | Privacy Practice | Privacy Sign-In Sheets | Privacy Sign-In Sheets | Privacy Sign-In Sheets | Privacy Sign-In Sheets |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| Form Size | 8.5" x 11" | 8.5" x 11.625" | 8.5" x 11.625" | 8.5" x 11.625" | 8.5" x 11.625" |
| Medical Form Pack Size | 250 | 125 | 125 | 125 | 125 |
| Print Type | Digital | Digital | Digital | Digital | Digital |
| Number of Parts | 8 | 3 | 3 | 3 | 3 |
| Pack Qty | 250 | 125 | 125 | 125 | 125 |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Price is $20.19
Delivery by Wed, Jun 18
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
Price is $17.39
Unit of measure 50/Pack
Delivery by Fri, Jun 13
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
Price is $21.19
Unit of measure 50/Pack
Delivery by Fri, Jun 13
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
Price is $45.79
Unit of measure 100/Pack
Free delivery by Fri, Jun 13
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
Price is $45.79
Unit of measure 100/Pack
Free delivery by Fri, Jun 13
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
Price is $31.09
Unit of measure 50/Pack
Delivery by Fri, Jun 13
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
Price is $45.79
Unit of measure 100/Pack
Free delivery by Fri, Jun 13
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
Price is $32.09
Unit of measure 100/Pack
Delivery by Fri, Jun 13
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
Price is $21.69
Delivery by Wed, Jun 18
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
Price is $45.79
Unit of measure 100/Pack
Free delivery by Fri, Jun 13
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
Price is $15.69
Unit of measure Dozen Price per unit $0.01/Post-it® Note
Delivery by Tue, Jun 10
1-hr 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
Price is $33.29
Delivery by Wed, Jun 18
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
Price is $36.79
Unit of measure 50/Pack
Free delivery by Fri, Jun 13
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
Price is $32.09
Unit of measure 50/Pack
Delivery by Fri, Jun 13
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
Price is $45.79
Unit of measure 50/Pack
Free delivery by Fri, Jun 13
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