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Request for Accounting of Disclosures (18242)
Path: Medical Forms Books & Envelopes -> HIPAA Forms -> Request for Accounting of Disclosures (18242)

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Request for Accounting of Disclosures
HIPAA "Request for accounting of disclosures" 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. 
Color: White
Size: 8-1/2" W x 11" H



ACS Low Prices
  Price is per pack, 200 per pack

1 - 2 : $18.75
3 - 5 : $17.75
6 or more : $16.75


Item #: 18242


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