Obtains a medical history and personal, financial and insurance info. Has special sections for Parent info., insurance authorization, and 2 Medical History Updates. Printed in Spanish on 20-lb. bond. 250 sheets per package. Size: 8-1/2×11″.
- Type of form: Dental registration and medical history form
- 250 per pack
- Size: 8 1/2″ x 11″
- Paper weight: 24 lbs
- Binding type: Loose
- Number of parts: 1
- Obtains a medical history and personal, financial and insurance info
- Has special sections for parent info
- Insurance authorization and 2 medical history updates
- Printed on 24 lbs. white ledger stock
Attribute name | Attribute value |
---|---|
Length in Inches The physical dimensions of the form. | 8 1/2″ x 11″ |
Width in Inches Actual manufacturer name for the color of the product. | White |
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