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, Spanish/English Bilingual, Blue (Pack of 125)

Model #: S-9355-BIL

$84.95 / Pack of 125

In Stock
Ships In 1-2 Days
Only 14 left in stock - order soon
Volume Pricing
6+ $82.95
  • 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. This version is bilingual with all the titles in spanish and english. 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 bilingual (spanish and english) blue.

Additional Information

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