Confidentially sign in your patients. Forms limit access to personal information as required by HIPAA. Patient signs in and waits to be called by name or number. Office staff removes numbered label strip with patient name and adheres it to patient chart to help improve record keeping. Once label strips have been removed, the patient information is now protected behind special backing paper. The sign-in form also provides confidential daily patient log. Forms numbered 1 - 23.

• Features
• Forms limit access to personal information as required by HIPAA.
• Once label strip is removed the patient information is now protected behind special backing paper.
• Can be used as confidential daily patient log as well as sign-in sheet.


• Specifications
• Copy Types Carbon Duplicate
• Finish Label Stock
• Form Quantity 125
• Form Size 8.5 x 11.63
• Forms Per Page 1
• Global Product Type Forms-Medical Admissions
• Layout One Form per Sheet
• Number of Columns 6
• Number of Entry Lines 23
• Numbering Color Black
• Numbering Preprinted Entry Lines
• Paper Color Green
• Post-Consumer Recycled Content Percent 0%
• Pre-Consumer Recycled Content Percent 0%
• Principal Heading Date Please Print Name Arrival Time Appt. Time Appointment With New Patient Any Changes Since Last Visit
• Print and Ruling Color Black
• Sheet Size 8.5 x 11.63
• Total Number of Entries per Book 2875
• Total Recycled Content Percent 0%