Medical Arts Press® Dental Registration and History Form; Elegant Brush
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HIPAA compliant insurance authorization. Size: 8-1/2x11". Screens for artificial heart valves, artificial joints, heart murmur, mitral valve prolapse and pacemaker. Help ensure reimbursement and improve risk management. Medication lists requests correlating diagnosis. Collects printed name and relationship to patient. 250 sheets per film wrapped pack



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