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COUNSELING INFORMATION FORM

COUNSELING INFORMATION FORM

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This Counseling Information form was developed in an effort to make it convenient for the pharmacist to comply with both the letter and the spirit of
OBRA-90.

We believe that this 5 ⅛” x 8 ¹⁄₁₆” form contains all the information you will need to counsel your patients, as well as supply you with much of the additional information you need for billing and filing insurance forms.

Available in English or Spanish.

QUANTITY

1,000 Sheets (10 Pads) for $89.95, 2,000 Sheets (20 Pads) for $143.50, 3,000 Sheets (30 Pads) for $189.95, 5,000 Sheets (50 Pads) for $289.50, 10,000 Sheets (100 Pads) for $515.25, 20,000 Sheets (200 Pads) for $895.45
Language

English, Spanish

Starts at $89.95
You save

1,000 Sheets (10 Pads) for $89.95 $89.95
You save
2,000 Sheets (20 Pads) for $143.50 $143.50
You save
3,000 Sheets (30 Pads) for $189.95 $189.95
You save
5,000 Sheets (50 Pads) for $289.50 $289.50
You save
10,000 Sheets (100 Pads) for $515.25 $515.25
You save
20,000 Sheets (200 Pads) for $895.45 $895.45
You save

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