CMS 1500 (8/05) Laser Insurance Forms

• Meets NEW CMS requirements
• 1 part laser form
• 8.5 x 11" cut sheet
• 1000/box

1000/box
Item #65473701 [09-29-06]   $25.38

CMS 1500 (8/05) 1-Part Continuous Insurance Forms

• Meets NEW CMS requirements
• 1 part continuous
• 9.5 x 11" with tractor feed edges
• 8.5 x 11" form
• 2500/box
• Multi-part available

2500/box
Item #35260100 [09-29-06]   $56.53

CMS 1500 (8/05) 2-Part Continuous Insurance Forms

• Meets NEW CMS requirements
• 2 part continuous form (white/white)
• 9.5 x 11" with tractor feed edges
• 8.5 x 11" form
• 1000/box

1000/box
Item #35262200 [09-29-06]   $52.73

Standard #10 Medical Claim Form Envelope

• Standard #10 size
• 24# White stock
• Touch & Seal flap
• Right hand window
• Inside Security Tint insures privacy

1000/box
Item #70070099    $84.69

Standard Full Page CMS Claim Envelope

• 9 X 12 1/2"
• 24# White stock
• Top flap opening
• Touch & Seal flap
• Right hand window
• First Class

1000/box
Item #70151099    $200.54

Progress Notes

• Standard format for easy record keeping
• 8.5 x 11" form
• Two hole drilled at top and bottom
  for easy insertion into charts
• Call for custom printing or format
• 1000/box

1000/box
Item #88150050    $85.67

Patient Registration

• Gather all patient information required by insurance carriers
• Reduce A/R by gathering accurate billing information
• 1 part 8.5 x 11" form
• Two hole drilled at top
• Call for custom formats and printing
• 1000/box

1000/box
Item #06306102    $56.90