PATIENT INTAKE FORM
Description:
Get Patient Information Efficiently
Patient Intake forms are perfect for your pharmacy tech to get all the necessary information when accepting new patients at the pharmacy. Don’t waste time asking the same questions twice!
- Forms are 5 ¼” high, 4 ⅛” wide
- They are printed in black ink on high quality 20 lb. canary paper
- In pads of 100
- Minimum quantity is 1,000 forms (10 pads)
*Also available in Pink, Green, or Blue. MINIMUM quantity of 5,000 required for paper colors other than Canary.
| QUANTITY | 1,000 (10 Pads) for $31.15, 2,000 (20 Pads) for $59.95, 3,000 (30 Pads) for $88.85, 5,000 (50 Pads) for $144.50, 10,000 (100 Pads) for $281.25 |
|---|---|
| Paper Choice | Canary – no minimum, Pink – 5,000 minimum, Green – 5,000 minimum, Blue – 5,000 minimum |
Starts at $31.15
You save
| 1,000 (10 Pads) for $31.15 |
$31.15 You save |
|
| 2,000 (20 Pads) for $59.95 |
$59.95 You save |
|
| 3,000 (30 Pads) for $88.85 |
$88.85 You save |
|
| 5,000 (50 Pads) for $144.50 |
$144.50 You save |
|
| 10,000 (100 Pads) for $281.25 |
$281.25 You save |