Patient Check In Sheet

In stock

Use of this HIPAA Check-In Sheet can help with:

  • Protecting your patients privacy and your staff of any HIPAA violations
  • Welcoming your patients to your office and remind them to notify staff of any insurance, address or phone number changes
  • Avoiding any question of fraud from Insurance companies by maintaining a master log of all patients seen by your office
  • Improved record keeping by attaching the signed removable adhesive strip to the patients chart
  • Being eco-friendly as this form has a unique 2 ply design eliminating the middle sheet that needs to be disposed on the 3 ply Sign- In Sheets.
  • 8-1/2 x 11-5/8 including top and bottom stubs
  • 2 part carbonless forms
  • Ply 1 - White Semi-Gloss label, printed in PMS 3005 Blue and Black
  • Ply 2 - White CF 20 #, printed in black on the face and back (back has instructions for use).
  • Sheets have 20 lines per form 125 forms per box 5 lbs. per box
More Information
MPN 1999
Packaging 1 per each
Size 8-1/2 x 11-5/8In
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