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    • Medical Statement Paper and Double Window Envelopes
    for Doctors, Healthcare Professionals & Medical Clinics
    Laser Statement Paper

    Print Business Statements
    with your Laser or Ink Jet Printer

    • 20# white laser Bond Paper
    • Distinctive shaded colored background
    • Heading information is computer generated. (We do not imprint forms)
    • "Remittance Portion" at top of form
    • Horizon Perforation 3-9/16" from top Edge
    • "Information Change Format"
      provided on Back of Remittance Portion
    • Folds easily into
      Self-Seal Double Window
      Statement Envelope


    BACK - Upper Portion of Statement

    Directory
     
    Business Statement

    No Charge Card Logos
    Available Blue (LCS101-BK) and Burgundy (LCS108-BK)
     Blue Statement
    No Logos
    LCS101-BK
    LCS101-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS101-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS101-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS101-BK
    10,000 ~ $350
    plus shipping by UPS
     Burgundy Statement
    No Logos
    LCS108-BK
    LCS108-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS108-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS108-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS108-BK
    10,000 ~ $350
    plus shipping by UPS
    Return to Directory
    Business Statement

    Visa and MasterCard Logos on front
    Available Blue (LCS101MC-BK) and Burgundy (LCS105-BK)
     Blue Statement
    Visa and MasterCard Logos
    LCS101MC-BK
    LCS101MC-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS101MC-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS101MC-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS101MC-BK
    10,000 ~ $350
    plus shipping by UPS
     Burgundy Statement
    Visa and MasterCard Logos
    LCS105-BK
    LCS105-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS105-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS105-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS105-BK
    10,000 ~ $350
    plus shipping by UPS
    Return to Directory
    Business Statement
     
    Visa, MasterCard and Discover Logos on front
    Available Blue (LCS106-BK) and Burgundy (LCS104-BK)
     Blue Statement
    Visa, MasterCard and Discover Logos
    LCS106-BK
    LCS106-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS106-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS106-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS106-BK
    10,000 ~ $350
    plus shipping by UPS
     Burgundy Statement
    Visa, MasterCard and Discover Logos
    LCS104-BK
    LCS104-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS104-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS104-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS104-BK
    10,000 ~ $350
    plus shipping by UPS
    Return to Directory
     Business Statement

    Visa, MasterCard, Discover and American Express Logos on front
    Available Only in Blue
     Blue Statement
    Visa, MasterCard, Discover and American Express Logos
    LCS107-BK
    LCS107-BK
    1,000 ~ $59.00
    plus shipping by UPS
    LCS107-BK
    2,500 ~ $115.00
    plus shipping by UPS
    LCS107-BK
    5,000 ~ $190.00
    plus shipping by UPS
    LCS107-BK
    10,000 ~ $350
    plus shipping by UPS

    Double Window Statement Envelopes

    Self-Seal Double Window Envelopes

      Window Size
    • 4-1/8" x 1"
      Bottom Window Position
    • 5/8" from bottom edge
    • 3/8" from left edge

    • 1/2" space between wondows

      • Easy to Use
      • No Moisture Needed
      • Fold up adhesive flap

      • Fold down envelope flap

      • Press together to seal

      Item#SS9A Double Window Statement Envelope
      1,000 ~ $105.00
      plus shipping by UPS
      2,500 ~ $188.00
      plus shipping by UPS
      5,000 ~ $330.00
      plus shipping by UPS
    "HIPAA" Compliant


    Patient Sign-In Log

    		 New
    Secure GuardTM
    Self Expiring
    Visitor Badges
    Self Expiring Visitor Badges
    		Secure Guard Paper
    8-1/2" x 11"
    PUNCHED LASER CUT SHEETS
    Health Care Formats

    special punch paperspecial punch paper
    and much more !

    For additional information relative to SECURE PRESCRIPTION FORMS,
    contact Micro Format at
    mailbox Support@4securitypaper.com

    Copyright © 2005-2009 Micro Format, Inc 
    All Rights Reserved 
    Micro Format, Inc. 
    830-3 Seton Court ~ Wheeling, IL 60090 
    847/520-4699 FAX 847/520-0197
    800-333-0549