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Notice of Privacy Practices- Patient Acknowledgement

SKU: PRV1-3 $49.65
Document patients' receipt of your privacy policy! Three-part form provides a copy for the patient, a copy for their chart, and a copy for the Privacy Officer's file.
-Two-hole punched at top.
-Size: 8-1/2"x11".
Prices include printing your practice name, address, and phone number up to 5 lines.
Both English & Spanish Versions available (Please indicate on order form).