• My Account
  • About Us
  • Contact Us
Ecom Folders – Medical File Folders | Chart Dividers | Filing Supplies
Search

CALL US NOW

(866) 336-5337

  • Home
  • File Folders
    • Manila File Folders
    • Color File Folders
    • Classification Folders
    • Folders with Pockets
    • Pressboard Folders
    • File Jackets
    • Expansion Pockets
    • Case Binders
    • Patent and Trademark Folders
  • File Dividers
    • Blank Divider Sheets
    • Chart Divider Sets
    • Fileback Divider Sets
    • Individual Dividers
    • Individual Fileback Dividers
    • Preprinted Divider Sheets
    • Self Adhesive Dividers
    • Custom Chart Dividers
      • Standard Dividers 90# White Stock
      • Standard Dividers 90# Manila Stock
      • Fileback Dividers 110# Manila Stock
  • Filing Accessories
    • Binder Strips
    • Conversion Products
    • Fasteners
    • Label Protectors
    • Out Guides
    • Self Adhesive Fasteners
    • Self Adhesive Pockets
    • Stick-On Tabs
    • X-Ray Jackets
  • File Labels
    • Alpha Labels
    • Numeric File Labels
    • Year Labels
    • Alert Labels
    • Allergy Warning Labels
    • Billing Collection Labels
    • HIPAA Labels
    • Insurance Labels
    • Label Tray
    • Name Labels
    • Reminder Labels
  • Additional Products
    • 1500 Claim Forms
    • Alpha Guides
    • Category Film Inserts
    • Film Mailers
    • Monthly Guides
    • Negative Preservers
    • Numeric Guides
    • Radiology Accessories
    • Sign In Sheets
  • My Account
  • About Us
  • Contact Us
  • Home
  • File Folders
    • Manila File Folders
    • Color File Folders
    • Classification Folders
    • Folders with Pockets
    • Pressboard Folders
    • File Jackets
    • Expansion Pockets
    • Case Binders
    • Patent and Trademark Folders
  • File Dividers
    • Blank Divider Sheets
    • Chart Divider Sets
    • Fileback Divider Sets
    • Individual Dividers
    • Individual Fileback Dividers
    • Preprinted Divider Sheets
    • Self Adhesive Dividers
    • Custom Chart Dividers
      • Standard Dividers 90# White Stock
      • Standard Dividers 90# Manila Stock
      • Fileback Dividers 110# Manila Stock
  • Filing Accessories
    • Binder Strips
    • Conversion Products
    • Fasteners
    • Label Protectors
    • Out Guides
    • Self Adhesive Fasteners
    • Self Adhesive Pockets
    • Stick-On Tabs
    • X-Ray Jackets
  • File Labels
    • Alpha Labels
    • Numeric File Labels
    • Year Labels
    • Alert Labels
    • Allergy Warning Labels
    • Billing Collection Labels
    • HIPAA Labels
    • Insurance Labels
    • Label Tray
    • Name Labels
    • Reminder Labels
  • Additional Products
    • 1500 Claim Forms
    • Alpha Guides
    • Category Film Inserts
    • Film Mailers
    • Monthly Guides
    • Negative Preservers
    • Numeric Guides
    • Radiology Accessories
    • Sign In Sheets
S-9355-GRN-1.jpg

Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Green (7 Packs of 125)

Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Burgandy (7 Packs of 125)
Patient-Sign In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Spanish/English Bilingual, Blue (7 Packs of 125)

$474.15

  • Each package contains 875 sheets with 25 signature lines per sheet (accommodates 21,875 total visits).
  • These sign-in sheets meet the privacy and confidentiality requirements of HIPAA.
  • The carbonless forms allows patients to sign-in without seeing other patent’s confidential information.
  • These sign-in sheets are blue.
SKU: S-9355B-GRN Category: Sign In Sheets

— OR —

Facebook Twitter LinkedIn Google + Email
  • Description
  • Additional information

Description

These HIPAA compliant patient sign-in sheets are a two part carbonless form with room for 25 signatures per page. Each patient prints their name and additional information on a numbered line. The office staff then removes the signed name label and either adds to the patient file or to a workflow tracking system. Once the label has been removed, the patient’s contact information is protected and only available to the office staff.

Additional information

Weight 28.00 lbs
Brand

Ecom Folders

Color

Green

Size

Letter Size

Material

Carbonless Form

Packaged

7 Packs of 125

Feature

Carbonless Form

Case Qty

875

Package Qty

875

Related products

  • Sign In Sheets

    Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Burgandy (Pack of 125)

    $69.99
    Add to cart
    Quick View
  • Sign In Sheets

    Patient-Sign In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Spanish/English Bilingual, Blue (Pack of 125)

    $69.99
    Add to cart
    Quick View
  • Sign In Sheets

    Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Blue (Pack of 125)

    $69.99
    Add to cart
    Quick View
  • Sign In Sheets

    Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Blue (7 Packs of 125)

    $474.15
    Add to cart
    Quick View
  • Sign In Sheets

    Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Green (Pack of 125)

    $69.99
    Add to cart
    Quick View
  • Sign In Sheets

    Patient Sign-In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Burgandy (7 Packs of 125)

    $474.15
    Add to cart
    Quick View
  • Sign In Sheets

    Patient-Sign In Sheets, HIPAA Compliant, 8-1/2″ x 11″ Carbonless Form, Spanish/English Bilingual, Blue (7 Packs of 125)

    $474.15
    Add to cart
    Quick View

Contact Info

  • Address: P.O. Box 1577, Kosciusko, MS 39090
  • Phone: (866) 336-5337
  • Email: info@ecomfolders.com
  • Working Days/Hours: Mon - Fri / 8:00 AM - 6:00 PM
Central
Facebook Twitter Pinterest

Customer Service

  • Contact Us
  • Site Terms and Policies
  • Shipping and Returns
  • My Account
  • About Us
  • Privacy Statement

Popular Categories

  • Manila File Folders
  • Sign In Sheets
  • Color File Folders
  • Custom Chart Dividers
  • Classification Folders
  • Year Labels
  • Pressboard Folders

Subscribe Newsletter

Get all the latest information on events, sales and offers. Sign up for newsletter:

Your name
Your email
© Copyright Ecom Business Solutions. All Rights Reserved.
has been added to your cart.
Checkout