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Tabbies Patient Privacy Sign-In Sheets, 2-Part, 125/Pack (TAB14530)
Item #: 901-2678550
Confidentially sign in your patients with guest-check forms
Business-form size: 11.63"L x 8.5"W
2 Part Carbon
$61.99
Per pack
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$46.99
Per carton
Adams 3-Part Carbonless Receipt Book, 10.88" x 7.63", 100 Sets/Book (TC1182)
Item #: 901-TC1182
Carbonless soft-cover money/receipt books for general receipts
Originals are white in color and copies are canary and pink in color and made of smooth carbonless paper for convenience
Contains one 100-receipt book per pack
$14.59
1-4 each
Save 5%
$13.79
5+ each
Tabbies 3-Part Patient Sign-in Label Forms, 125/Pack (14532)
Item #: 901-2678548
Patient sign-in label forms to sign in your patients confidentially
Form consists of three parts: a label sheet, a carbon sheet, and a log behind it
125 sheets per package
$82.99
Per pack
Adams® Carbonless Receipt Book, 3" x 8", 2-Part, 200 Sets/Book (SC1182)
Item #: 901-SC1182
Rent receipt books for recording monthly financial payments
Carbonless paper creates white originals and canary duplicates
Four forms per page and 50 pages; 200 forms per book
$12.99
1-3 each
Save 3%
$12.59
4+ each
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$35.99
Per pack
Adams 2-Part Carbonless Receipt Book, 5" x 11", 200 Sets/Book (SC1152)
Item #: 901-SC1152
Money/rent receipt book for recording rent payments and other payments
White originals and canary duplicates and made of carbonless paper
Contains 200 receipts per book; four forms per page
$10.79
1-4 each
Save 7%
$9.99
5+ each
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 901-CMS12LC250
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
$20.99
Per box
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 2,500 (CMS12LC)
Item #: 901-125557
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$71.39
Per pack
Medical Arts Press® Tamper-Resistant Secure Rx/2-Part Carbonless
Item #: 901-13377
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Medical Arts Press® Progress Notes; Reinforced, Top Punched
Item #: 901-20555
Provides plenty of room to record patient progress and your findings at subsequent visits
Record patient name, birth date and gender
Ruled back side
$61.99
Per pack
Adams 2-Part Carbonless Sales Orders, 8.44"L x 5.56"W, 50 Sets/Book (DC5805)
Item #: 901-196113
Sales and order books are ideal for keeping proper records of orders and sales
Business form size: 5.56"W x 8.44"L; detached: 5.56"W x 7.94"L
2-Part White/Canary Carbonless forms for accurate record keeping
$8.59
1-7 each
Save 6%
$7.99
8+ each
New Customers
Medical Arts Press® Dental Registration and History Form
Item #: 901-20605
Form allows you to gather complete information from patients
Simple to fill out with individually numbered sections
Includes sections on patient information, insurance, history and more
$49.99
1-3 pack
Save 4%
$47.99
4+ pack
Adams 2-Part Carbonless Receipts Book, 2.75" x 4.88", 50 Forms/Book (DC2501)
Item #: 901-DC2501
Money and rent receipt book is consecutively numbered for easy organization
Size: 2.75"L x 5.38"W; detached 2.75"L x 4.88"W
2-Part Carbonless forms for accurate record keeping
$6.49
1-5 each
Save 9%
$5.89
6+ each
Quill® Economy Columnar Pads for Prong Fasteners; 6 Columns
Item #: 901-745806
20-lb. ledger green paper
10,000,000 units per column
6 columns; Description Column is 1-7/8" wide
$81.99
Per pack
Quill® Economy Columnar Pads for Prong Fasteners; 4 Columns
Item #: 901-745804
20-lb. ledger green paper
50 numbered lines, every fifth horizontal line heavily ruled as line guide
10,000,000 units per column
$65.99
Per pack
Medical Arts Press® Chiropractic Registration and History Form
Item #: 901-21701
Forms ensure reimbursement, improve risk management and document your clinical process
Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness
Also features areas for severity, onset, effect on daily activities, and co
$62.99
1-3 pack
Save 3%
$60.99
4+ pack
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
Item #: 901-519727
Designed for hospitals to file a medical claim with the patient's insurance carrier
One-part health insurance forms
Contains 2500 forms per carton
$110.99
Per carton
Adams 2-Part Carbonless Sales Orders, 4.17"L x 7.2"W, 50 Sets/Book, 10/Box (DC4705-10)
Item #: 901-DC470510
Sales and order books are ideal for keeping proper records of orders and sales
Size: 7.19"L x 4.19"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$79.99
Per pack
Medical Arts Press® Continuation Notes, White, No Punch Option
Item #: 901-20131NP
Type of form: Continuation note
500 per pack
Size: 8 1/2" x 11"
$46.99
Per pack
Chiropractic Registration and History Form without Updates, Sky Blue
Item #: 901-20572
Forms ensure reimbursement, improve risk management and document your clinical process
Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness
Also features areas for severity, onset, effect on daily activities, and co
$61.99
1 pack
Save 8%
$56.99
2+ pack
Medical Arts Press® Tamper-Resistant Laser Rx Paper; 1 RX Blank/Sheet, High Security, 500/Pack
Item #: 901-83405
Security features exceed industry guidelines and meet all Medicaid requirements
Void pantograph - the word "VOID" appears when form is photocopied
Chemical protection - stains or spots appear with chemical alteration
Medical Arts Press® 2-Part Rx Blanks; Carbonless, 4x5-1/2"
Item #: 901-16022MAP
2-part carbonless; yellow duplicate
Standard refill instructions
Specify state license and/or DEA numbers, if desired
TOPS Credit Card Sales 3-Part Carbonless Receipt, 3.25"L x 7.88"W, 100/Pack (TOP 38538)
Item #: 901-810999
Triplicate Credit Card Sales Slips are made with carbonless paper to protect your customers; no carbon tissues containing credit card information to worry about
Size: 3.25"L x 7.88"W
Features a carbonless 3-part format and comes in white
$32.99
1-4 pack
Save 3%
$31.99
5+ pack