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Home > MEDICAL / CHIROPRACTIC > Medical Forms > HIPAA Forms >

Generic Privacy Sign-In

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FREE SHIPPING! Buy 3 packs of this Item and get FREE SHIPPING!

First Time Buyers use this Code FTB-1995 to receive a 10% Discount on This Product, just type the code into the coupon box at check out and hit apply.

List Price: $115.00

Your Price: $85.95

You Save $29.05!

Unit Qty: 125
Unit: pack
Overall Dimensions: 8-1/2" W x 11"

Product Code: W-GN-14037

Shipping

Shipping Charge*:

Order 1 - 2 Boxes or Packs Shipping Cost is $19.95
Order 3 or More Boxes or Packs Shipping is FREE!

Qty:

Description

Freight, Returns & Sales Tax Policies

Confidential Sign-In Sheets now have 27 sign in positions!
Columns
1) Number
2) Please Print Name
3) Appointment With'
4) Arrival Time
5) Appt. Time

Are you getting the best value for your Confidential Sign-In Sheets?

Most sign-in sheets have 20, 23 or 25 sign-in positions.
With ACS you get 27 sign-in positions per sheet which equals 250 more sign-ins per pack of 125.

20 positions / 125 sheet pack = 2,500 sign-ins
23 positions 125 sheet pack = 2,875 sign-ins
25 positions / 125 sheet pack = 3,125 sign-ins
27 positions / ACS Sign-in 125 sheet pack = 3,375 sign-ins.

More value for your Dollar.

FREIGHT CHARGES
ACS always confirms to our customers total amount to be charged including freight costs before order
is processed.

RETURNS
There is a 15 day return policy. Customers have 15 days to return products after they have received them. Products are not returnable after this time. Returns are subject to a restocking fee of 25%. If the return is a result of our error, we will issue a call tag. We grant returns on products only if the product and the packaging are in re-sellable condition. Custom products are not returnable.

SALES TAX
ACS charges sales tax if you are a Texas resident, Texas State Sales Tax will be added at the time your
order is invoiced. If you are tax exempt you must provide a Texas Sales Tax Exemption Certificate.

Colors & Features

How to use this form:
- The 27 signature lines are a peel off adhesive label.
- The Signature labels are numbered 1-27.
- Visitor signs in on the next available signature line
- Their information is transferred through a carbonless sheet to a visitor log sheet on the back of the form.
- If you use the number to call the visitor, instruct the visitor after signing to remove the number from the left-hand column next to their signature line.
- The receptionist then may peel off the precut signature line of visitor information.
- The visitor information is not visible to other visitors at this point. The security cover sheet (part 2 of the form) says "Please Use Next Line".
- After completing an entire sheet or at the end of each day, separate the sheet by breaking the snap-set at the top and bottom perforations. Discard the top two sheets, you now have a complete, private list of all patients and their information. You can use these complete lists for reporting, daily audits or office records.