HIPAA Patient Sign-in Sheet

A new and inexpensive, easy to use Patient Sign-In Form that keeps your patients' names confidential and your office HIPAA compliant. Each sign-in line is a separate label. There are no messy peg-board forms and spindles to use. Your patient signs in, your staff removes the label and puts it on the patient's chart. The patients information is now invisible on the label sheet. Your patient is given the little number on the left side of the label that matches the number on the label strip . Patient is called by the number to keep his/her name confidential. When the sheet is filled, remove the top sheet (glued at top and bottom). The bottom sheet is your record with all information visible.

Two part form- carbon interleaved
- part 1 - label stock with slits to remove each patient's name from view after they sign in.
- part 2 - record of patients. Keeps your patient's names private.
Form is glued so that part two, the record of patients, will be a complete listing of the patients seen (invisible to patients until the completed form is opened up by staff.
Subsequent patients see just the blank form
Patients can be called by number instead of name

sheets	patients per sheet	no. of patients	cost	View Cart
250	25	6.250	$106.40
500	25	12,500	$164.60
1000	25	25,000	$263.80
2000	25	50,000	call for special pricing
3000	25	75,000	call for special pricing
5000	25	125,000	call for special pricing

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