Patient Sign-in Label Form Patient Sign-In Label Form HEALTHCARE FORMS 10 Confidential Forms W-CSGN Each patient prints his/her name, appointment time and “Name of Healthcare Professional” on a numbered line. If using the optional numbered label, patient takes the number. The office staff removes the signed name label and either adds to the patient file or to a workflow tracking system. Once the label has been removed, the information is protected behind part one. Available only for office use. • The front desk attendant calls each patient by name or number. • Each package contains 125 forms, numbered 1 through 25, or enough forms to see 3125 patients. • NEW! Out-0f-Country format Each patient prints his/her name, arrival time and “Name of Healthcare Professional” on a numbered slip, then removes it. Once the patient removes the slip, the information is protected behind the carbonless paper available only for office use. • The front desk attendant reads the log and calls each patient by name or number. • Each kit contains 40 sets, numbered 1 through 25, or enough slips to see 1,000 patients. 3-Part Patient Sign-in System 3-Part Patient Sign-in System Item No. Description Pkg. Qty. Weight W-SGNKIT 3-Part Sign-in System 40 7 Lbs. W-JSGN Patient Slips 40 6 Lbs. W-SGNKIT (Pegboard Board W1185BL plus 1,000 Patient Slips) W-JSGN (1,000 Patient Slips) 3-Part Patient Sign-in System Patient Sign-in Label Form Item No. Color Pkg. Qty. Weight Carton Qty Carton Wht W-PSGN Blue 125 6 Lbs 875 41 Lbs W-PSGN-BY Burgundy 125 6 Lbs 875 41 Lbs W-PSGN-GN Green 125 6 Lbs 875 41 Lbs W-PSGN-PUR Purple 125 6 Lbs 875 41 Lbs W-PSGN-OR Orange 125 6 Lbs 875 41 Lbs W-PSGN-BIL Blue 125 6 Lbs 875 41 Lbs W-PSGN-OOC Blue 125 6 Lbs 875 41 Lbs W-PSGN W-PSGN-BY W-PSGN-GN W-PSGN-BIL W-PSGN-OOC W-PSGN-PUR W-PSGN-OR Confidential Sign-In Label Form Item No. Color Pkg. Qty. Weight Carton Qty Carton Wht W-CSGN White/Yellow 125 6 Lbs 875 41 Lbs
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