CLINICAL FORMS C A B D CLINICAL FORMS Sign-In Sheets 367-3603 367-9238 367-4603 367-3546 A–C. PADDED SIGN-IN SHEETS D. WELCOME SIGN-IN FORM • Welcome your patients with style! • Each design has enough room for 50 patient names and arrival times • Printed on 28 Lb. ledger stock in pads of 100 Description Qty. Price 2@ 5@ 1-Sided, 81⁄2”W x 11”H 100/PK $13.49 $12.49 $10.49 • Welcome patients with this classic form! • Enough room for 44 patient names and appointment times Description Qty. Price 2@ 1-Sided, 81⁄2”W x 11”H 100/PK $32.29 $31.29 5@ $29.29 G F E 367-1046 367-1050 367-1047 E–G PATIENT SIGN-IN SHEETS • Removable strip protects patient privacy • Carbon sheet transfers names to the back sheet • Available in 3 different designs Description Qty. Price 1-Sided, 81⁄2”W x 11”H 100/PK $59.99 H 2@ $58.99 5@ $56.99 H. HIPAA PRIVACY SIGN-IN SHEETS • Removable strip protects patient privacy • Carbon sheet transfers names to the back sheet • Available in 3 different colors Description Qty. Price 1-Sided, 81⁄2”W x 11”H 250/PK $69.49 Imprinted Materials: 800.414.0940 8am–5pm (ET) 2@ $68.29 5@ $66.29 Salmon Blue Green 367-1043 367-1044 367-1045 Call To Order: 800.372.4346 8am–9pm (ET) 153http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3673603%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3679238%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3674603%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3673546%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671046%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671047%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671050%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671043%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671044%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671045%26CatalogName%3DDENTAL