ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
$45.39
1
Highlights
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- Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare provider
- HIPAA compliant
- Size: 8 1/2" x 11"
MADE IN AMERICA
ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354)
Item #: 398026Model #: A1354
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| Attributes | ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) | ComplyRight HIPAA Patient Consent and Authorization Form (A1350) | ComplyRight Notice of Privacy Practice, 100/Pack (A1349) | ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500) | ComplyRight Confidential Employee Medical Records Folder, Pack of 25 (A2211) |
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Your product ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice (A1354) Price is $45.39 | |||||
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| Delivery Information | Free delivery by Thu, Jun 18 | Free delivery by Thu, Jun 18 | Delivery by Thu, Jun 18 | Free delivery by Tue, Jun 16 | Free delivery by Thu, Jun 18 |
| Available in my store | No | No | No | No | No |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 9.375 |
| Length in Inches | 11 | 11 | 11 | 11 | 11.75 |
| Form Size | 8 1 / 2" x 11" | 8 1 / 2" x 11" | 8 1 / 2" x 11" | 8-1 / 2" x 11" | 9.375" x 11.75" |
| Medical Form Type | Privacy Practice | Consent | Privacy Practice | Dental Claims | Medical Records Folders |
| Medical Form Pack Size | 200 | 200 | 100 | 500 | 25 |
| Pack Qty | 200 | 200 | 1 | Data not available | 1 |
| True Color | White | White | White | White | Data not available |
| Print Type | Inkjet / Laser | Inkjet / Laser | Data not available | Laser | Data not available |
| Number of Parts | 1 | 1 | Data not available | 1 | Data not available |
| Series or Collection | Patient Acknowledgment of Receipt | HIPAA Patient Consent and Authorization Form | Data not available | Data not available | ComplyRight |
| Price Per Unit | Data not available | Data not available | Data not available | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
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