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HIPAA Forms and Posters
Item# HPOSTER1
Notice of Privacy Practices Poster
Poster for Notice of Privacy Practices informs patients of your practice's privacy policies. For use in waiting and exam rooms. Personalized with practice name, address, phone & privacy officer. 12" x 18", 110# white index stock with your choice of border.
Quantity: Up to 4 $35.50
Quantity: 5-9 $15.50
Quantity: 10 or more $9.75
Item# HSTP1
Small HIPAA Staff Training Poster
Small HIPAA Staff Training Poster reminds staff of the do's and don'ts of patient privacy according to HIPAA. One side for posting in reception area, the other for medical records area. 8.5" x 11", buff colored, laminated.
Quantity: Up to 2 $11.25
Quantity: 3-4 $8.25
Quantity: 5-9 $7.25
Quantity: 10 or more $6.25
Item# HSTP2
Large HIPAA Staff Training Poster
Large HIPAA Staff Training poster reminds staff of the do's and don'ts of good patient privacy practices. For use in all office areas. 12" W x 18" H, buff colored, one sided.
Quantity: Up to 2 $13.25
Quantity: 3-4 $10.25
Quantity: 5-9 $9.25
Quantity: 10 or more $8.25
Item# HPH1
Notice of Privacy Practices Form
Notice of Privacy Practices Form is used to notify patients about your use and protection of health information, as required by HIPAA. Personalized with your practice name. 8.5" x 11", two sided, black type on white paper. Sold in lots of 100. Quantity discounts. $15.00 Proof Charge.
Quantity: Up to 4 $65.85
Quantity: 5-9 $23.25
Quantity: 10 or more $16.00
Item# HACK1
'Acknowledgement of Receipt' form
Acknowledgement of Receipt' is signed by patients who have received notification of your practice's privacy policies (see Notice of Privacy Practices). Personalized with your practice name. Hole-punched for easy insertion into patient chart. 8.5" x 11"
Quantity: Up to 4 $43.50
Quantity: 5-9 $13.75
Quantity: 10 or more $10.75
Item# 14037
HIPAA Compliant Sign In Sheet
HIPAA Compliant Sign-In Sheet protects your patients' privacy. After they sign in, peel label off of top form leaving the information imprinted on bottom of form for staff use. 8.5" x 11", black ink on salmon form. 250/pkg.
Quantity: Up to 1 $67.50
Quantity: 2-4 $65.50
Quantity: 5-9 $63.50
Quantity: 10 or more $61.50
Item# 18228
HIPAA Compliant Sign In Sheet
HIPAA Compliant Sign-In Sheet protects your patients' privacy. After they sign in, peel label off of top form leaving the information imprinted on bottom of form for staff use. 8.5" x 11", black ink on blue form. 250/pkg.
Quantity: Up to 1 $67.50
Quantity: 2-4 $65.50
Quantity: 5-9 $63.50
Quantity: 10 or more $61.50
Item# 18229
HIPAA Compliant Sign In Sheet
HIPAA Compliant Sign-In Sheet protects your patients' privacy. After they sign in, peel label off of top form leaving the information imprinted on bottom of form for staff use. 8.5" x 11", black ink on green form. 250/pkg.
Quantity: Up to 1 $67.50
Quantity: 2-4 $65.50
Quantity: 5-9 $63.50
Quantity: 10 or more $61.50
Item# HINDEX-BT
HIPAA index, bottom tab
HIPAA Index (bottom tab)- Keep your signed acknowledgements and other HIPAA related paperwork under this index tab. Manila stock, reinforced and two-hole punched at top. 1/3 cut with red tab. Sold in lots of 100.
Quantity: Up to 4 $43.50
Quantity: 5-9 $32.50
Quantity: 10 or more $28.00
Item# HINDEX-ST
HIPAA Index, side tab
HIPAA Index (side tab)- Keep your signed acknowledgements and other HIPAA related paperwork under this index tab. Manila stock, reinforced and two-hole punched at top. 1/3 cut with red tab. Sold in lots of 100. Quantity discounts on 5 and 10 lot orders only.
Quantity: Up to 4 $56.00
Quantity: 5-9 $42.25
Quantity: 10 or more $36.00
Item# MAP697
2007 Authorization Label
2007 Authorization label shows which medical records are up to date regarding HIPAA items. 1 1/4" W x 5/16" H. Green with black type. 500 labels per roll.
Quantity: Up to 9 $8.95
Quantity: 10 or more $8.55
Item# MAP698
2008 Authorizations Label
2008 Authorization label shows which medical records are up to date regarding HIPAA items. 1 1/4" W x 5/16" H. Fluorescent red with black type. 500 labels per roll.
Quantity: Up to 9 $8.55
Quantity: 10 or more $8.30