Search
Categories

  Home > MEDICAL / CHIROPRACTIC > Medical Forms > Encounter Forms / Superbills >

Custom Encounter Forms
Encounter Forms / Superbills
 
ACS Custom Encounter/Superbills; 9-1/2" x 11" Continuous Pin-feed, Perforated out to 8-1/2" x 11", 1-Part. Customer to provide art work if available. If not send us your previous sample, sketch or typewritten draft and layout of what you want us to print we will do the rest. Make sure your codes are up-to-date and accurate.

9-1/2" x 11" One Part Pinfeed Includes
  • Custom Print Front
  • Forms are printed with your choice of codes, descriptions and formats.
  • Continuous
  • 1 part White 20# bond
  • 9-1/2” x 11”
  • Your Choose of One Ink Color - Black, Brown, Burgundy, Green, Orange, Process Blue, Red, Reflex Blue
  • After Approved Proof Ships in 7 Working Days
  • Quantities Over 10,000 Ship In 10 Working Days

Add-Ons for Additional Charges
Numbering $55.00
Second Color $90.00
Print Back Copy Black Ink $90.00
3 Day Rush Orders Ships in 3 Days After Approved Proof $175.00

Email all Art to [email protected]
Mail to: ACS PO Box 5088 Georgetown, Texas 78627

Choose Your Options Below and Then Click Update Price to See Your Total Price.



Product Code: ES9.5-1

Choose Your Quantity

500 [Add $215.00]
1,000 [Add $245.00]
2,500 [Add $437.50]$175.00 per 1,000
5,000 [Add $725.00]$145.00 per 1,000
10,000 [Add $1,150.00]$115.00 per 1,000
20,000 [Add $1,900.00]$95.00 per 1,000
Choose Your Ink Color
Click to view another Choose Printing Ink Color

 Black
Brown
Burgundy
Green
Orange
Process Blue
Red
Reflex Blue
Add a Second Ink Color

No Second Color
Black [Add $90.00]
Brown [Add $90.00]
Burgundy [Add $90.00]
Orange [Add $90.00]
Process Blue [Add $90.00]
Red [Add $90.00]
Reflex Blue [Add $90.00]
Printing Back Copy One Color

No Back Copy
Print Back Copy Black Ink [Add $90.00]
Numbering

No Numbering
Numbering [Add $55.00]
Staring Number


3 Day Rush Order

No Need To Rush
3 Day Rush Order [Add $175.00]

Qty:  
Description Freight, Returns & Sales Tax Policies
 
ACS Custom Encounter/Superbills; 9-1/2" x 11" Continuous Pin-feed, Perforated out to 8-1/2" x 11", 1-Part. Customer to provide art work if available. If not send us your previous sample, sketch or typewritten draft and layout of what you want us to print we will do the rest. Make sure your codes are up-to-date and accurate.

9-1/2" x 11" One Part Pinfeed Includes
  • Custom Print Front
  • Forms are printed with your choice of codes, descriptions and formats.
  • Continuous
  • 1 part White 20# bond
  • 9-1/2” x 11”
  • Your Choose of One Ink Color - Black, Brown, Burgundy, Green, Orange, Process Blue, Red, Reflex Blue
  • After Approved Proof Ships in 7 Working Days
  • Quantities Over 10,000 Ship In 10 Working Days

Add-Ons for Additional Charges
Numbering $55.00
Second Color $90.00
Print Back Copy Black Ink $90.00
3 Day Rush Orders Ships in 3 Days After Approved Proof $175.00

Email all Art to [email protected]
Mail to: ACS PO Box 5088 Georgetown, Texas 78627

Products Frequently Bought Together
Numeric Label QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet Medi-Clip/Docu-Clip 11 pt Manila 2 Ply End Tab
Your Price: $22.95

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $49.95

Add Free Shipping
Your Price: $48.95

Add
Numeric Label QuickStrip File Folder Labels, 6-up on 8.5 x 11 Sheet Docuclip Fastener Sturdy Rigid 11 pt Manila 2 Ply End Tab Folder
Month Label Custom 8 Tab Poly Divider Set Bilingual Privacy Patient Sign-In ACS Sliding Lateral Track
Your Price: $10.95

Add Free Shipping
Your Price: $4.69

Add Free Shipping
Your Price: $85.95

Add Free Shipping
Your Price: $6,500.00

Add Free Shipping
Month Label <!010>Custom 8 Tab Poly Divider Set Bilingual Privacy Patient Sign-In ACS Lateral Track Movable Shelving Systems
TAB Match Year Label Double Ply Top Tab Pocket End Tab Expansion Pockets Times 2 Speed Cabinet
Your Price: $13.95

Add
Your Price: $79.95

Add Free Shipping
Your Price: $79.00

Add Free Shipping
Your Price: $4,500.00

Add
Year Label Double Ply Top Tab Pocket <!001>End Tab Expansion Pockets Times 2 Speed Files
14 pt Manila 2 Ply End Tab Radiology Jacket ALLERGY LABEL 11 pt 2 Ply Color End Tab Folders
Your Price: $56.95

Add Free Shipping
Your Price: $185.00

Add Free Shipping
Your Price: $10.95

Add Free Shipping
Your Price: $240.00

Add Free Shipping
Heavy Duty 14 pt Manila 2 Ply End Tab Folder Radiology Jacket Non-Color Coded ALLERGY LABEL 11pt Reinforced Solid Color End Tab Folders
Poly Stick-On Pockets 36" Wide File Shelving Outguides Custom 6 Tab Fileback Set
Your Price: $45.95

Add Free Shipping
Your Price: $725.00

Add Free Shipping
Your Price: $79.50

Add Free Shipping
Your Price: $3.18

Add Free Shipping
Poly Stick-On Pockets 36 Single Entry Letter Size 4 Post Starter Unit Outguides <!004>Custom 6 Tab Fileback Set
Heavy Duty Vinyl Stick-On Pockets Alpha Label Barkley Match Custom 6 Tab Divider Set
Your Price: $55.95

Add Free Shipping
Your Price: $13.95

Add
Your Price: $2.43

Add Free Shipping
Heavy Duty Vinyl Stick-On Pockets Barkley FABKM Match <!004>Custom 6 Tab Divider Set

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 / CHIROPRACTIC > Medical Forms > Encounter Forms / Superbills
MEDICAL / CHIROPRACTIC > Medical Forms


Tab Products Match
BILLING & COLLECTION LABELS
<!024>2-Ply End Tab Folder Installed Kraft Pocket
11 pt 2 Ply Color End Tab Folders
Tab Products Match
BILLING & COLLECTION LABELS
2-Ply End Tab Folder Installed Kraft Pocket
11 pt 2 Ply Color End Tab Folders
$11.95
$10.95
$72.00
$36.00