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Type of form: Registration form
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250 per pack
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Size: 8 1/2″ x 11″
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Paper weight: 24 lbs.
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Binding type: Loose
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Number of parts: 1
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Gathers important information you need for your records, quickly and easily
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Includes sections for patient and insurance information, history, and authorization and release
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Printed both sides on 24 lbs. bond




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