3-Part Notice of Privacy Practices HIPAA Acknowledgment - 5 pads of 25 forms each

A clear, compact form that documents patient receipt of your privacy policy.

• Please note: 25 forms per pad - 5 pad minimum.
• 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.