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FORMS

Pink

Blue

Green

790-14037 790-18228 790-18229

250/box……

$76.75

250/box……

$76.75

250/box……

$76.75

HIPAA Peel-able Privacy Sign-In Sheets

- IFS Filing Systems LLC

Removable labels for added security. Meet the needs of your patient’s privacy expectations. Patients fill in information line on the remov-

able strip, the carbon sheet transfers that information to the back sheet so other patients don’t see the previous person’s information.

8-1/2” x 11”.

PATIENT PRIVACY SIGN -IN FORMS

Smile Sign-In

Toothbrush Graphic Sign-In

790-17008 790-17014

100/box……

$67.45

100/box……

$67.45