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Request for Access to Protected Health Information (18240)
Path: Medical Forms Books & Envelopes -> HIPAA Forms -> Request for Access to Protected Health Information (18240)

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Request for Access to Protected Health InformationHIPAA
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 #: 18240