Description
Obtains a medical history and personal, financial and insurance info. Has special sections for Parent info. , insurance authorization, and 2 Medical History Updates. Printed in Spanish on 20-lb. bond. 250 sheets per package. Size: 8-1/2x11". Binding type: Loose. Obtains a medical history and personal, financial and insurance info. Printed on 24 lbs. white ledger stock. Size: 8 1/2" x 11". Number of parts: 1. 250 per pack. Insurance authorization and 2 medical history updates. Paper weight: 24 lbs. Type of form: Dental registration and medical history form. Has special sections for parent info