3-Part Notice of Privacy Practices HIPAA Acknowledgment

Item#: PRV2 Size: 5 1/2 x 8 1/2"
Quantity 5 10 20 40 60
PRV2-3  3-Parts/Triplicate $115.99 $215.99 $358.99 $595.99 $889.99
We recommend this quantity.
2. Add "Companion" Products
 

Product Benefits and Features

A clear, compact form that documents patient receipt of your privacy policy.

  • Please note: 25 forms per pad - 5 pad minimum.
  • Personalization includes: Your imprinted practice name, address, and phone number, up to 5 lines. 3-part form provides copies for patient, chart and privacy officer.