Description
- Forms limit access to personal information as required by HIPAA.
- Once label strip is removed the patient information is now protected behind special backing paper.
- Can be used as confidential daily patient log as well as sign-in sheet.
Confidentially sign in your patients. Forms limit access to personal information as required by HIPAA. Patient signs in and waits to be called by name or number. Office staff removes numbered label strip with patient name and adheres it to patient chart to help improve record keeping. Once label strips have been removed, the patient information is now protected behind special backing paper. The sign-in form also provides confidential daily patient log. Forms numbered 1 - 23.
| Form Type Details | Medical Admission |
| Dated/Undated | Undated |
| Forms Per Page | 1 |
| Form Size | 8.5 x 11.63 |
| Sheet Size | 8.5 x 11.63 |
| Format | Unbound |
| Form Quantity (Total) | 125 |
| Copy Types | Two-Part Carbon |
| Principal Heading(s) | Date; Please Print Name; Arrival Time; Appt. Time; Appointment With; New Patient; Any Changes Since Last Visit |
| Columns per Sheet | 6 |
| Number of Entry Lines | 23 |
| Paper Color(s) | Blue |
| Color Family | Blue |
| Print and Ruling Color(s) | Black |
| Numbering Color(s) | Black |
| Product Biodegradability in Days | 0 |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Special Features | Blue Sheets |
