If you are using Internet Explorer as your browser, you must use Explorer 10.0 or later to use our online store!
To order by phone call toll free: 1-877-840-1500

LABORATORY MOUNT SHEETS

Physician's Telephone Orders DTO4

DTO4
Physician's Telephone Orders
CLICK TO ENLARGE

Usage: Allows for 1 to 10 telephone messages to be posted for collection and viewing purposes in the patient's chart. Message forms need to be at least 5" in width to fit our stock form. Can be used in 3 ring left binder and 2, 3 or 5 hole top chart style.

Base Specifications:

Size: 8 x 11
Paper: 20# White
Ink: PMS 347 Green
Punching: Punch 5 holes left & 5 top
Fastening: 2 Permanent Tapes – " x 11"
         1 finger lift size
        die cut into 9 sections
Packaging: 250 per Inner Box
         500 per Carton

Description

Quantity/Case

Price/Case

Secure Order

Physician's Telephone Orders DTO4

500

$161.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Physician's Telephone Messages DTM4

DTM4
Physician's Telephone Messages
CLICK TO ENLARGE

Usage: Allows for 3 ring binder filing or use. Write each message as needed. Pull out from vertical perf at left for the length of message, then pull down and separate on horizontal perf.

Fill in stub notes at left, remove transfer tape on back of message form and stick to patients chart for permanent and easy viewing.

Special Design Features:

  • Die cut to fit each message form
  • Each message from size is 2 3/4'" x 6"
  • Highlights medication allergy to alert medical personnel

Base Specifications:
Size: 8 x 11
Paper: 20# White RB
Ink: PMS 347 Green
Punching: Punch 3 holes left – 4-1/4 cc (1/4")
Perforations: 1 Full Vertical Perf
          3 Partial Horizontal Perfs

Fastening: 2 Permanent Tapes – " x 11" On Back

Packaging: 250 per Inner Box
         500 per Carton

Description

Quantity/Case

Price/Case

Secure Order

Physician's Telephone Messages DTM4

500

$195.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports

 

Laboratory Reports DC5

 5 sections, 2 strips of " horizontal tape with slits, 5 holes top, red ink, white paper.

DC-5
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DC5
Laboratory Reports

500

$175.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DVT3

3 sections, 2 strips of " vertical tape with slits, 5 holes top, reflex blue ink, white paper

DVT3
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DVT3
Laboratory Reports

500

$198.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DVT5

5 sections, 2 strips of " vertical tape with slits, 5 holes top, reflex blue ink, white paper

DVT5
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DVT5
Laboratory Reports

500

$195.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DH3

3 sections, 3 strips of " horizontal tape, 5 holes top, black ink, canary paper

DH-3
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DH3
Laboratory Reports

500

$175.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DH5

5 sections, 5 strips of " horizontal tape, 5 holes top, black ink, canary paper

DH5
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DH-5
Laboratory Reports

500

$195.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DD5

5 sections, 2 strips of " horizontal tape with slits, 5 holes top, black ink, canary paper

DD5
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DD5
Laboratory Reports

500

$190.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

 

Laboratory Reports DVT13

13 sections, 2 strips of " vertical tape with slits, 5 holes top, black ink, canary paper

DVT13
Laboratory Reports
CLICK TO ENLARGE

Description

Quantity/Case

Price/Case

Secure Order

DVT13
Laboratory Reports

500

$200.00


Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

ALL OUR FORMS ARE OF THE HIGHEST QUALITY, ARE PRINTED IN STRICT COMPLIANCE WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE INSURANCE INDUSTRY.
OUR FORMS HAVE BEEN APPROVED BY THE GOVERNMENT.
The American HCFA Forms division of DFL Enterprises, Inc. is an independent supplier of US Government
approved claim forms and NOT an affiliate of CMS (
www.cms.gov)

WE ACCEPT VISA, MASTERCARD and AMERICAN EXPRESS

This Site is Secured by:

IF YOU HAVE ANY QUESTIONS OR TO ORDER BY PHONE
CONTACT US TOLL FREE AT:
 1-877-840-1500
FAX: 1-985-809-5788
Our Office Hours are:
 Monday - Thursday: 8am - 5pm CST
Friday: 8am - 12 noon CST

EMAIL US

AMERICAN HCFA FORMS is a Division of
124 Pine Oak Dr., Covington, LA 70433
PHONE: 985-875-0800
FAX: 1-985-809-5788

Home HCFA-1500 Forms  CMS-1500 Forms  UB04 Forms  UB-92/CMS-1450/HCFA-1450 Forms 
CMS 485,486,487 Forms  Claim Form Envelopes  HIPAA Compliance Forms
Printing Services  Contact Us

Associated sites:
DFL-Enterprises.com | hcfa1500forms.com | claimformsdepot.com
HIPAASignIn.com | ub92.net | discountclaimforms.com

Copyright © 1998 - 2010 DFL Enterprises, Inc.
Find us on the
New Orleans Web Site Directory