FORM, HIPAA PATIENT SIGN-IN SHEET (125/PK)
- Forms limit access to personal information as required by HIPAA.
- Once label strip is removed the patient information is now protected behind special backing paper.
- Can be used as confidential daily patient log as well as sign-in sheet.
| McKesson # | 996162 |
|---|---|
| Manufacturer # | TAB-14531 |
| Manufacturer | Tabbies® |
| Country of Origin | United States |
| Color Family | Blue |
| Columns per Sheet | 6 |
| Copy Types | Two-Part Carbon |
| Dated/Undated | Undated |
| Form Quantity (Total) | 125 |
| Form Size | 8.5 x 11.63 |
| Form Type Details | Medical Admission |
| Format Indicator | Unbound |
| Forms Per Page | 1 |
| Global Product Type | Medical Admission Forms |
| Number of Entry Lines | 23 |
| Numbering Color(s) | Black |
| Paper Color(s) | Blue |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Principal Heading(s) | Any Changes Since Last Visit |
| Print and Ruling Color(s) | Black |
| Sheet Size | 8.5 x 11.63 |
| Special Features | Blue Sheets |
| Total Recycled Content Percent | 0% |
| UNSPSC | 14111806 |
