Patient Sign-in Sheets, Bilingual 8-1/2" X 11" (Blue) Carbonless Form (Lot of 875 Sheets) HIPAA Compliant

★★★★★ 4.2 80 reviews

US$94.38
Price when purchased online
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US$94.38
Price when purchased online
Free shipping Free 30-day returns

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Product details

Management number 219315237 Release Date 2026/05/03 List Price US$94.38 Model Number 219315237
Category

Each patient prints his/her name, appt time/arrival time, appointment with and if they're a new patient or if there are any changes in the phone, address or insurance since the last visit. Once the label has been removed, the information is protected behind part one, available only for office use.

  • Maintain HIPAA compliance and keep patient information confidential thanks to the security sheet attached below the sign in sheet, so each patient can sign in safely without seeing information of other patients
  • Easily conceal patient information from public view while retaining a daily log of your sign in sheet for reference or audit purposes. Sign in information is instantly imprinted onto the transfer sheet below, yet remains securely blocked from the view of others
  • Each line on the signin sheet peels off to become a self-adhesive label sticker, which can be then applied directly to the patient folder, form, or other office records
  • 875 = 7 packs (125 sheets per pack) - accommodates 21,875 patient visits
Size Letter
Color Blue
Material Paper; Carbonless 3-part
Brand Name twihealthcare
Unit Count 875.0 Count
Item Weight 6 Pounds
Part Number TWI-WPSGN-BIL
Manufacturer twihealthcare
Model Number TWI-WPSGN-BIL
Mounting Type Wall Mount
Number of Pieces 875
Pre Printed Text Letter
Item Dimensions L x W 11"L x 8.5"W

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80 ratings | 33 reviews
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