Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care
$80.99
Per pack
Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care
Item #:
901-15165
Model #:
15165
Brand:
Medical Arts Press
(1 reviews)
Item #:
901-15165
$80.99
Per pack
250 EACH = 1 PACK
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Medical Arts Press® Chiropractic Registration and History Forms, Holistic Care
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Description
- Forms ensure reimbursement, improve risk management and document your clinical process
- Comprehensive color forms include areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity
- Also includes areas for onset, effect on daily activities, and conditions
- HIPAA-compliant insurance authorization
- Accident information alerts to different reimbursement source
- Check box for minors and space for school information
- 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
- Full color, Printed 2 sides on 24 lb. stock
- Sold 250 forms per package
Specifications
Brand
Medical Arts Press
Form Size
8 1/2" x 11"
Length in Inches
11
True Color
White
Width in Inches
8.5