Home > MEDICAL > Medical Forms > HIPAA Forms >

Custom Privacy Patient Sign-In
Privacy Patient Sign-In


 
FREE SHIPPING!
Buy 3 packs of this Item and get FREE SHIPPING!
Less than 3 packs Flat Shipping Rate $9.95
List Price: $265.00
Your Price: $150.00
Deal of the Day Price: $120.00
You Save $145.00!
Unit Qty: 100
Unit: pack
Overall Dimensions: 8-1/2" W x 11"

Product Code: C-PS-DM-2P
Qty:

Description Freight, Returns & Sales Tax Policies
 
The ACS NEW Custom Patient Sign-in Log / HIPAA Compliant

  • Your Company Information & Logo.
  • Customize Your Own Columns.
  • 2 parts (Duplicate Log Sheet)
  • Printed in Black Ink.
  • 20 sign in positions on each sheet.
  • Sheets are 8-1/2” x 11”.
  • Price includes set up costs.
  • Shipping is a flat $9.95 for 200 or less, anything from 300 up is free shipping.
  • Ships in 5 working days on approval of proof.
After you place your order, you will be contacted for your design and imprint info. Then you will receive an email or fax proof of your design before we go to press with your order. This gives you a chance to make any last minute changes before it's printed.

How it works:


1. Keeps patient visits private
Each patient completes the form's top line - a self-adhesive strip that includes a removable
number to give to patients if you wish to call them by number instead of name.

2. Updates the chart
Before the next patient signs in, the receptionist removes the strip and places it either on a
call sheet or into the chart. The completed label alerts you to changes in patient information.

3. Protects confidentiality
The label liner keeps the duplicate record hidden from patients that follow. Once the form is
completed, detach the edges (which discourage peeking) to discard the liner and release the log.

4. Verifies billing and keeps an audit trail
The Patient Sign-In log automatically creates a duplicate record sheet of every appointment, which you can file away or store in a binder. This log also helps you analyze wait times and better manage patient volume and flow.



Features
  • You can have your Facility imprint, Doctors names, and (or) custom fields for patients to sign-in on. Below are just examples to serve as idea starters of what is possible. Contact us and we can help you customize your form.



    Facility Name centered, Facility Address in top left, Participating Doctors in top right,custom sign-in fields. This form for a Pediatric office includes a blank for "Parent Name".



    Facility Name centered, custom sign-in fields. This form for an Ob/Gyn office includes checkboxes for "New Patient" and "Changes since last visit".

  • Simple title of Form centered, Doctor Name in top left, Facility Address in top right, custom sign-in fields. General sign-in sheet template.

  • Facility Name centered, custom sign-in fields. This Radiology office example can have text added to the top right and left corners of the page.

  • Simple title of Form centered, Facility Name & Address in top left, Participating Doctors in top right, custom sign-in fields. General sign-in sheet template.

  • Facility Name centered, custom sign-in fields. This Internal Medicine office
    example includes "Name", "Date", "Time Arrived", "Time of Appointment" and "Doctor".



Share your knowledge of this product with other customers... Be the first to write a review

Browse for more products in the same category as this item:

MEDICAL > Medical Forms > HIPAA Forms
MEDICAL > Medical Forms > Confidential Patient Sign-In Sheets
DENTAL > Dental Forms > HIPAA
DENTAL > Dental Forms > Dental Patient Sign-In Forms
VETERINARY > Forms, Checks and Letterhead > Confidential Patient Sign-In Sheets
CHIROPRACTIC > Medical Forms and Books > HIPAA Forms
CHIROPRACTIC > Medical Forms and Books > Confidential Patient Sign-In Sheets
BUSINESS/GOVERNMENT > Forms and Books > Confidential Patient Sign-In Sheets
MEDICAL > HIPAA Compliant Products
MEDICAL
MEDICAL > Medical Forms
DENTAL > Dental Forms
VETERINARY > Forms, Checks and Letterhead
CHIROPRACTIC > Medical Forms and Books
BUSINESS/GOVERNMENT > Forms and Books
DENTAL
VETERINARY
CHIROPRACTIC
BUSINESS/GOVERNMENT