3-Part Notice of Privacy Practices HIPAA Acknowledgment<br/> 5 1/2 x 8 1/2"
A clear, compact form that documents patient receipt of your privacy policy. Personalization includes: Your imprinted practice name, address, and phone number, up to 5 lines. 3-part form provides copies for patient, chart and privacy officer. Please note: 25 forms per pad - 5 pad minimum. SIZE: 5 1/2 x 8 1/2"

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