Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
$16.79
5+ pad
Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
Item #:
901-QFN132131R
Model #:
7QGFM132131R
Brand:
Quill Custom Print
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Sale
$16.79
5+ pad
100 EACH = 1 PAD
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Description
Professional note certifies that a patient under your care has been totally or partially incapacitated for a period of time.
- For certification of care
- 8-1/2" W x 5-1/2" L
- White 20# text stock; printed in black ink
- 100 sheets per pad, order in quantities of 5 pads
- Padded at the top
Specifications
# Up Per Sheet/Page
1
Binding Type
Padded
Brand
Quill Custom Print
Carbonless
No
Color
White
Customizable
Yes
Form Size
5-1/2" x 8-1/2"
Form Type
Insurance
Format
Medical Chart
Holes Punched
No
Lines
7
Media Quantity
100
NCR Paper
No
Number of Parts
1
Numbered
No
Package Quantity
100 per Pad
Personalization
Yes
Security Features
No
Sheet Size
5-1/2" x 8-1/2"