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
Loading...
Customers also viewed
Medical Arts Press® Chiropractic Registration and History Form
Item #: 901-21701
Chiropractic Registration and History Form without Updates, Sky Blue
Item #: 901-20572
Medical Arts Press® Comprehensive Examination Form
Item #: 901-21700
Medical Arts Press® Vehicle Accident Information Form
Item #: 901-20546
Medical Arts Press® Chiropractic Forms; Travel Card
Item #: 901-21704
Medical Arts Press® Take Home Instructions
Item #: 901-13870M
Medical Arts Press® Dental Registration and History Form; Tooth Border
Item #: 901-20596
Medical Arts Press® Dental Registration and History Form, English
Item #: 901-20129NP
Medical Arts Press® Progress Notes Patient Care Form; Green FormFamily™
Item #: 901-20381
Medical Arts Press® Registration Form; Smile Team™
Item #: 901-21784
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