Actual product color may vary. We would be happy to send a color swatch if exact match is required. Contact us for more detials.

Patient Sign-In Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Blue (Pack of 125)

Model #: S-9355-BLU

$80.91 / Pack of 125

In Stock
Ships In 1-2 Days
Volume Pricing
6+ $79.23
  • Description
  • Product Details

Product Description

These HIPAA compliant patient sign-in sheets are a two part carbonless form with room for 25 signatures per page. Each patient prints their name and additional information on a numbered line. The office staff then removes the signed name label and either adds to the patient file or to a workflow tracking system. Once the label has been removed, the patient's contact information is protected and only available to the office staff.

  • Each package contains 125 sheets with 25 signature lines per sheet (accomodates 3,125 total visits).
  • These sign-in sheets meet the privacy and confidentiality requirements of HIPAA.
  • The carbonless forms allows patients to sign-in without seeing other patent's confidential information.
  • These sign-in sheets are blue.

Additional Information

Brand:Ecom Folders
Color:Blue
Special Features:Carbonless Form
Folder Material:Carbonless Form
Packaged:Pack of 125
Product Group:Business Forms
Product Type:Business Forms
Size:Letter Size
Sub Category:Sign In Sheets