Medical Arts Press® Chiropractic Registration and History Forms, Botanical
$79.99
1 pack
Save 6%
$74.99
2+ pack
Medical Arts Press® Chiropractic Registration and History Forms, Botanical
Item #:
901-15164
Model #:
15164
Brand:
Medical Arts Press
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$79.99
1 pack
Save 6%
$74.99
2+ pack
250 EACH = 1 PACK
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Details
Limited quantity available: 17 remaining
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Description
Medical Arts Press Botanical Registration and History Forms - Include a space for recording patient history, reason for visiting and information related to injury
Medical Arts Press Botanical Registration and History Forms are made in compliance with HIPAA standards. They feature a check box for minors along with space for school information.
- Improved forms ensure reimbursement, improve risk management and document your clinical process
- Areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity, onset, effect on daily activities, constancy and progression of symptoms
- HIPAA-compliant insurance authorization
- Accident information alerts to different reimbursement source
- Check box for minors and space for school information
- Check box for patients in non-married relationships
- Flexible patient ID number accommodates social security number, your patient ID system, or health insurance claim number
- Occupation, employer name, address and phone; emergency and pharmacy contacts
- Printed on 24lb. stock; size: 8-1/2x11"
Specifications
Brand
Medical Arts Press
Pack Qty
1