Patient Confidentiality Sign-In Sheet

PATIENT CONFIDENTIALITY SIGN-IN SHEETS
Shingled Set Version

Up to 25 shingled tickets printed on bond sheets are glued to a two-part carbonless set. Some hospitals prefer to have the tickets consecutively numbered on the body of the ticket and on a stub that is given to the patient. This allows the office staff to call the patient by either name or number. Nothing transfers to the first part of the set, but does transfer to the second part - which is not visible to the patient but becomes a permanent record of the patients who have visited the office that day.

Each set includes 20 sign-in tickets.

Shingled Tickets, numbered in two positions, record the patient's registration
information. The ticket is filled out by the patient and detached from
the booklet. The patient retains the numbered stub and gives the ticket
to the receptionist. This allows the health care provider the option of
calling in patients by their name OR by their number on the stub receipt.

As the registration progresses, as patients sign in, they cannot view the
names above theirs due to the block out of information on page one
of the two part log sheets. The second journal page records each line entry
of registration. The two journal sheets are spot glued on both sides to
prohibit viewing of the logged information.

This is a SECURE Document

Unlike other forms, special security features built into the Micro Format
Patient Confidentiality Sign-In Log give both the health care
professionals and the patient privacy while transacting the
medical information process during office visits.

Item# PSL20 Each "Sign-In Sheet" includes 20 sign-in tickets	PSL20 50 sets ~ $125.00
	PSL20 100 sets ~ $205.00
	PSL20 200 sets ~ ($195.00 per 100) ~ $390.00
	PSL20 400 sets ~ ($185.00 per 100) ~ $740.00
	PSL20 600 sets ~ ($169.00 per 100) ~ $876.00

PATIENT CONFIDENTIALITY SIGN-IN SHEETS
Label Version

The label version is a two-part set with part one being label material. The second part a bond sheet with a sheet of carbon paper in between. There are slits below each line that allow office staff to remove each entry as the patient signs in. The strip is then attached either to the patient's chart or to the sheet outlining the reason for the patient's visit. All of the information transfers to the second part of the form and becomes a permanent record of the patients who have visited that day.

Each set contains 20 numbered strips.

Label strips, numbered in two positions. record the patient's registration
information. The strip is filled out by the patient and removed from the top page. The patient retains the small numbered stub and gives the long strip
to the receptionist. This allows the health care provider the option of
calling in patients by their name OR by their number on the stub receipt.

As the registration progresses, as patients sign in, they cannot view the
names above theirs since the entire registration label has been removed from the top page. The second journal page records each line entry of registration.
The label sheet and the journal sheet is glued on both sides to
prohibit viewing of the logged information.

This is a SECURE Document

The Special security features are built into the Micro Format
Confidential Sign-In Log give both the health care
professionals and the patient privacy while transacting the
medical information process during office visits.

Item# CSL20 Each "Sign-In Log" includes 20 sign-in label strips	CSL20 200 sets ~ $165.00
	CSL20 500 sets ~ $350.00
	CSL20 1000 sets ~ $500.00