Healthcare Practice Forms and Supplies


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Request for Restriction of Patient Health Care Information

Our Price: $21.85

Item Number: 18241

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Request for Restriction of Patient Health Care Information
HIPAA "Request for restriction of patient health care information" form complies with HIPAA standard privacy security transactions. Printed on one side 20 lb. white stock black ink. Two drill holes on top. 200 forms per package. Overall size 8-1/2" W x 11" H.

SKU: 18241
Unit of Measure: PCKG
Color: White
Size: 8-1/2" W x 11" H
Quantity: 200/Pkg