Products

ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF HEALTH INFORMATION PRACTICES

Finished Size: 8.5 x 11
Digital: Color
Sides: Single
Stock: 28# Color Copy White
Finishing:
Unit: Pack [100/pk]
$25.86

25.86

SKU 91-CONS-130

ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF HEALTH INFORMATION PRACTICES-SPANISH

Finished Size: 8.5 x 11
Digital: Color
Sides: Single
Stock: 28# Color Copy White
Finishing:
Unit: Pack [100/pk]
$25.86

25.86

SKU 91-CONS-130-SP

AGAINST MEDICAL ADVICE

Finished Size: 8.5 x 11
Digital: Color
Sides: Single
Stock: 28# Color Copy White
Finishing:
Unit: Pack [100/pk]
$25.86

25.86

SKU 91-CONS-113

AL AUTHORIZATION FOR USE AND DISCLOSURE OF PHI

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-CONS-115

CONSENT FOR INFANT TO STAY WITH MOTHER DURING HOSPITALIZATION

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-119

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing: 2-Hole Drill
Unit: Pad [100/pd]
$12.86

12.86

SKU 91-CONS-101

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD -SPANISH

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing: 2-Hole Drill
Unit: Pad [100/pd]
$12.86

12.86

SKU 91-CONS-101-SP

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD_ORANGE-5

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# Salmon
Finishing: 5-Hole Drill
Unit: Pad [100/pd]
$13.49

13.49

SKU 91-CONS-1003-O-5

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD_ORANGE-5

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# Salmon
Finishing: 5-Hole Drill
Unit: Pad [100/pd]
$13.49

13.49

SKU 91-CONS-1001-O-5

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD_ORANGE3

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# Salmon
Finishing: 3-Hole Drill
Unit: Pack [100/pk]
$13.49

13.49

SKU 91-CONS-1002-O-3

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD_SPANISH_ORANGE

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# Salmon
Finishing: 3-Hole Drill
Unit: Pad [100/pd]
$13.49

13.49

SKU 91-CONS-1001-SP-O

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD-CWPP

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-CONS-108-CWPP

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD-CWPP_ORANGE

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# Orange
Finishing:
Unit: Pad [100/pd]
$10.49

10.49

SKU 91-CONS-108-CWPP-ORANGE

CONSENT FOR SURGERY, ANESTHETICS, BLOOD PROD, OTHER PROD-EGD

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-CONS-109-EGD

CONSENT FOR TREATMENT

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-100

CONSENT FOR TREATMENT OF NEWBORN

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing: 2-Hole Drill
Unit: Pad [100/pd]
$12.86

12.86

SKU 91-CONS-102

CONSENT FOR TREATMENT-SPANISH

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-100-SP

CONSENT FOR VAGINAL DELIVERY AFTER CESAREAN (VBAC)

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-107

CONSENT TO PHOTOGRAPH

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-104

CONSENT TO STRESS TESTING

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-110

CONSENT TO SUPPLEMENT THE EXCLUSIVELY BREASTFED NEWBORN

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-121

GOOD FAITH ESTIMATE

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-REG-104

INFORMED CONSENT FOR VACCINATION

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-120

MEDICAL TRANSPORT REFUSAL AND CONSENT TO SELF TRANSPORT

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-125

MODEL BILLING BALANCE 11 x 17 POSTER

Finished Size: 11 x 17
Digital: Color
Sides: Single
Stock: 80# Silk Cvr
Finishing: Lamination, Flush Cut
Unit: Pad [100/pd]
$161.76

161.76

SKU 91-REG-106

MODEL BILLING BALANCE 8.5 X 11

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-REG-105

NO SUICIDE CONTRACT

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-123

NOPP

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing: Corner Staple
Unit: Pad [100/pd]
$16.06

16.06

SKU 91-REG-101

NOPP ACKNOWLEDGEMENT

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-REG-110

NOPP ACKNOWLEDGEMENT - SPANISH

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-REG-110-SP

NOPP POSTER 11 x 17

Finished Size: 11 x 17
Digital: Color
Sides: Single
Stock: 80# Silk Cvr
Finishing: Lamination, Flush Cut
Unit: Pad [100/pd]
$161.76

161.76

SKU 91-REG-102

NOPP POSTER 11 x 17 - SPANISH

Finished Size: 11 x 17
Digital: Color
Sides: Single
Stock: 80# Silk Cvr
Finishing: Lamination, Flush Cut
Unit: Pad [100/pd]
$161.76

161.76

SKU 91-REG-102-SP

NOPP POSTER 16 x 20

Finished Size: 16 x 20
Digital: Color
Sides: Single
Stock: 3 MM PVC Sintra Board
Finishing:
Unit: Each
$10.80 ea

10.80

SKU 91-REG-103

NOPP POSTER 16 x 20 - SPANISH

Finished Size: 16 x 20
Digital: Color
Sides: Single
Stock: 3 MM PVC Sintra Board
Finishing:
Unit: Each
$10.80 ea

10.80

SKU 91-REG-103-SP

NOPP SPANISH

Finished Size: 8.5 x11
Digital: Black
Sides: Single
Stock: 20# White
Finishing: Corner Staple [4pgs]
Unit: Pad [100/pd]
$20.06

20.06

SKU 91-REG-101-SP

NOTICE OF NONDISCRIMINATION

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-REG-112

OPT OUT FORM

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-124

PATIENT ACCESS CODE

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-REG-113

PATIENT CONSENT TO HIV TEST

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 2-Part NCR
Finishing:
Unit: Pad [100/pd]
$18.31

18.31

SKU 91-CONS-106

PATIENT GUIDE CARDS - BIRMINGHAM

Finished Size: 3.75 x 2.25
Digital: Color
Sides: Single
Stock: 100# Accent Cvr
Finishing:
Unit: Pack [100/pk]
$25.00

25.00

SKU 91-REG-116

PATIENT GUIDE CARDS - BLOUNT

Finished Size: 3.75 x 2.25
Digital: Color
Sides: Single
Stock: 100# Accent Cvr
Finishing:
Unit: Pack [100/pk]
$25.00

25.00

SKU 91-REG-120

PATIENT GUIDE CARDS - CHILTON

Finished Size: 3.75 x 2.25
Digital: Color
Sides: Single
Stock: 100# Accent Cvr
Finishing:
Unit: Pack [100/pk]
$25.00

25.00

SKU 91-REG-118

PATIENT GUIDE CARDS - EAST

Finished Size: 3.75 x 2.25
Digital: Color
Sides: Single
Stock: 100# Accent Cvr
Finishing:
Unit: Pack [100/pk]
$25.00

25.00

SKU 91-REG-117

PATIENT GUIDE CARDS - ST. CLAIR

Finished Size: 3.75 x 2.25
Digital: Color
Sides: Single
Stock: 100# Accent Cvr
Finishing:
Unit: Pack [100/pk]
$25.00

25.00

SKU 91-REG-119

PATIENT RIGHTS AND RESPONSIBILITIES - ENGLISH

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-REG-108

PATIENT RIGHTS AND RESPONSIBILITIES - SPANISH

Finished Size: 8.5 x 11
Digital: Black
Sides: Double
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$9.86

9.86

SKU 91-REG-108-SP

PATIENT RIGHTS AND RESPONSIBILITIES 11 X 17 POSTER - ENGLISH

Finished Size: 11 x 17
Digital: Color
Sides: Single
Stock: 80# Silk Cvr
Finishing:
Unit: Pad [100/pd]
$37.76

37.76

SKU 91-REG-109

PATIENT RIGHTS AND RESPONSIBILITIES 11 X 17 POSTER - SPANISH

Finished Size: 11 x 17
Digital: Color
Sides: Single
Stock: 80# Silk Cvr
Finishing:
Unit: Pad [100/pd]
$37.76

37.76

SKU 91-REG-109-SP

PAYMENT DUE AT TIME OF REGISTRATION [WALL CLING]

Finished Size: 5 x 7
Digital: Color
Sides: Single
Stock: Wall Cling
Finishing:
Unit: Each [1/pk]
$10.00

10.00

SKU 91-REG-115

PEDIATRIC HEP-B VACCINE INFORMED CONSENT

Finished Size: 8.5 x 11
Digital: Black
Sides: Single
Stock: 20# White
Finishing:
Unit: Pad [100/pd]
$5.86

5.86

SKU 91-CONS-103

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