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Custom Encounter Forms
Encounter Forms / Superbills
 
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ACS Custom Encounter/Superbills; 9-1/2" x 11" Continuous Pin-feed, Perforated out to 8-1/2" x 11", 3 - Parts. 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" Three Parts Pinfeed Includes
  • Custom Print Front
  • Forms are printed with your choice of codes, descriptions and formats.
  • Continuous
  • 3 part White 16# CB, Canary 15# CFB & Pink 15# CF
  • 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: ES9.5-3

Choose Your Quantity

500 [Add $360.00]
1,000 [Add $380.00]
2,500 [Add $787.50]$315.00 per 1,000
5,000 [Add $1,225.00]$245.00 per 1,000
10,000 [Add $1,950.00]$195.00 per 1,000
20,000 [Add $3,500.00]$175.00 per 1,000
Choose Your 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", 3 - Parts. 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" Three Parts Pinfeed Includes
  • Custom Print Front
  • Forms are printed with your choice of codes, descriptions and formats.
  • Continuous
  • 3 part White 16# CB, Canary 15# CFB & Pink 15# CF
  • 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

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