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    Patient Confidentiality Sign-In Log

    This is one of the best systems available
    Sample Available - Please call Customer Service

    The Health and Human Services Patient Privacy Act
    regarding patient health information (PHI) establishes
    requirements and guidelines for protection of patient
    records in the health care system.

    Information as it applies to
    "the Health and Human Services Patient Privacy Act"
    can be reviewed on the United States Department of Health and Human Services web site
    http://hhs.gov/ocr/hipaa/

    The use of a Patient Sign-in Sheet is still permissible.
    However the Privacy Act prohibits "Reason for Visit"
    Information to be available to public view.

    Is your office "hipaa" compliant? ~ Link to "hipaa" privacy rules

    The Micro Format Document Security Paper Division's
    PATIENT CONFIDENTIALITY SIGN IN LOG
    hides not only the "Reason for Visit" Information
    but the "PATIENT'S NAME" as well.


    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 Log" includes
    20 sign-in tickets

    		 50 sets ~ $99.00
    100 sets ~ $188.00
    200 sets ~ ($177.00 per 100) ~ $354.00
    400 sets ~ ($166.00 per 100) ~ $664.00
    600 sets ~ ($149.00 per 100) ~ $876.00

    Micro Format Customer Service - (800)333-0549

    "prescriptionpaper.com","rxpaper.com" and "scriptpaper.com"
    are domain names and trade marks owned by Micro Format, Inc.
    Copyright © 2003-2009 Micro Format, Inc ~ Wheeling, IL
    ALL RIGHTS RESERVED
    830-3 Seton Court ~ Wheeling, IL 60090
    847/520-4699~In the USA call Toll Free 800-333-0549
    FAX 847/520-0197
    e-mail: support@microformat.net