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Quill® Economy Columnar Pads for Prong Fasteners; 4 Columns
Item #: 901-745804
20-lb. ledger green paper
50 numbered lines, every fifth horizontal line heavily ruled as line guide
10,000,000 units per column
$65.99
Per pack
Quill® Economy Columnar Pads for Prong Fasteners; 6 Columns
Item #: 901-745806
20-lb. ledger green paper
10,000,000 units per column
6 columns; Description Column is 1-7/8" wide
$81.99
Per pack
Staples® Columnar Books, 100 Pages, Green, 2/Pack (217869)
Item #: 901-217869
Columnar book is ideal for accounting and record keeping
Eye-ease green-tinted paper
Includes 100 single-format pages with 6 columns
$23.59
1-3 pack
Save 3%
$22.79
4+ pack
Chiropractic Registration and History Form without Updates, Sky Blue
Item #: 901-20572
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
Also features areas for severity, onset, effect on daily activities, and co
$61.99
1 pack
Save 8%
$56.99
2+ pack
Medical Arts Press® Progress Notes; Reinforced, Top Punched
Item #: 901-20555
Provides plenty of room to record patient progress and your findings at subsequent visits
Record patient name, birth date and gender
Ruled back side
$69.99
Per pack
Medical Arts Press® Treatment Notes, Tooth #, Non-Imprinted, No Punch
Item #: 901-20560NP
Type of form: Treatment note
250 per pack
Size: 8 1/2" x 11"
$49.99
1-3 pack
Save 4%
$47.99
4+ pack
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$46.99
Per carton
Adams 3-Part Carbonless Receipt Book, 10.88" x 7.63", 100 Sets/Book (TC1182)
Item #: 901-TC1182
Carbonless soft-cover money/receipt books for general receipts
Originals are white in color and copies are canary and pink in color and made of smooth carbonless paper for convenience
Contains one 100-receipt book per pack
$14.59
1-4 each
Save 5%
$13.79
5+ each
Adams 2-Part Carbonless Receipt Book, 5" x 11", 200 Sets/Book (SC1152)
Item #: 901-SC1152
Money/rent receipt book for recording rent payments and other payments
White originals and canary duplicates and made of carbonless paper
Contains 200 receipts per book; four forms per page
$11.29
1-4 each
Save 6%
$10.59
5+ each
Adams® Carbonless Receipt Book, 3" x 8", 2-Part, 200 Sets/Book (SC1182)
Item #: 901-SC1182
Rent receipt books for recording monthly financial payments
Carbonless paper creates white originals and canary duplicates
Four forms per page and 50 pages; 200 forms per book
$13.49
1-3 each
Save 2%
$13.09
4+ each
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 901-CMS12LC250
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
$20.99
Per box
Adams 2-Part Carbonless Sales Orders, 8.44"L x 5.56"W, 50 Sets/Book (DC5805)
Item #: 901-196113
Sales and order books are ideal for keeping proper records of orders and sales
Business form size: 5.56"W x 8.44"L; detached: 5.56"W x 7.94"L
2-Part White/Canary Carbonless forms for accurate record keeping
$9.09
1-7 each
Save 6%
$8.49
8+ each
New Customers
Staples 13 Columns Columnar Book, 16.31"W x 11"H, Green (217893)
Item #: 901-217893
Green tinted paper
Includes 50 single-format pages with 13 columns
Overall dimensions: 16.31"W x 11"H
$20.99
1-4 each
Save 1%
$20.59
5+ each
Adams 2-Part Carbonless Receipts Book, 2.75" x 4.88", 50 Forms/Book (DC2501)
Item #: 901-DC2501
Money and rent receipt book is consecutively numbered for easy organization
Size: 2.75"L x 5.38"W; detached 2.75"L x 4.88"W
2-Part Carbonless forms for accurate record keeping
$6.99
1-5 each
Save 7%
$6.49
6+ each
Staples Columnar Book, 50 Pages, Green (217885)
Item #: 901-217885
Columnar book is ideal for accounting and record keeping
Green-tinted paper with green and black lines
Includes 50 pages with 12 columns
$21.59
1-3 each
Save 3%
$20.79
4+ each
Adams Write 'N Stick 2-Part Carbonless Receipts Book, 2.75" x 4.75", White, 200 Forms/Book (SC1152WS)
Item #: 901-SC1152WS
Receipt book is consecutively numbered for easy organization
Business-form size: 2.75"L x 4.75"W
2-Part Carbonless forms for accurate record keeping
$24.79
1-4 each
Save 3%
$23.99
5+ each
Medical Arts Press® 2-Part Rx Blanks; Carbonless, 4x5-1/2"
Item #: 901-16022MAP
2-part carbonless; yellow duplicate
Standard refill instructions
Specify state license and/or DEA numbers, if desired
Rediform Gold Standard 2-Part Carbonless Receipts Book, 5"L x 2.75"W, 225 Forms/Book (8L829)
Item #: 901-8L829
Receipt book is consecutively numbered for easy organization
Business form size: 5"L x 2.75"W
2-Part Carbonless forms for accurate record keeping
$29.99
Per each
Medical Arts Press® Tamper-Resistant Secure Rx/2-Part Carbonless
Item #: 901-13377
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Adams 3-Part Carbonless Invoices, 8.44"W x 5.56"L, 50 Sets/Book (TC5840)
Item #: 901-196170
Invoice book is great for the office or on the go
Form size: 8.44"W x 5.56"L
3-Part Carbonless forms for accurate record keeping
$12.49
1-5 each
Save 3%
$12.09
6+ each
Medical Arts Press® Tamper-Resistant Laser Rx Paper; 1 RX Blank/Sheet, High Security, 500/Pack
Item #: 901-83405
Security features exceed industry guidelines and meet all Medicaid requirements
Void pantograph - the word "VOID" appears when form is photocopied
Chemical protection - stains or spots appear with chemical alteration
Adams 2-Part Carbonless Invoices, 5.5625" x 8.4375", 50 Sets/Book (DC5840)
Item #: 901-DC5840
Invoice book for keeping financial records of sales
White sheets for originals and canary for copies
Pack of one containing 50 invoices per book
$7.49
1-5 each
Save 6%
$6.99
6+ each
Tabbies Patient Privacy Sign-In Sheets, 2-Part, 125/Pack (TAB14530)
Item #: 901-2678550
Confidentially sign in your patients with guest-check forms
Business-form size: 11.63"L x 8.5"W
2 Part Carbon
$64.99
Per pack
Rediform Visitor Book, 9.88" x 8.5", Black, 64 Sheets/Book (RED57802)
Item #: 901-909724
Place a visitor book in your lobby or reception area to welcome guests or log those who have visited your business
Includes pages of white recycled paper within high-quality black hardcover
Each sheet includes 14 lines per page for 1792 total entries on 128 pages
$45.99
Per each