 Prices 
			We have a full variety of 
			Health Care Forms:
  Prices 
			We have a full variety of 
			Health Care Forms:  
SAMPLES: 
			
			60 Days Summ.Samples   
			Agreement Samples    
			Adm. Order Samples
			
			ABN Notice Samples         Adv. Directives Samples 
			Affidavits Samples 
			
			Authorization to Sign       
			BP Logs Samples        			
			Bill of Rights Samples 
			
			
			Behavior Sample              
			Behavior 
			Sample 2 
  			
  		        BS Log Samples
			
			 Credit Card Auth.            
			
			Case Conf. Samples    Clinic/MD Office Forms
			
			 Communication LOG       
			Consents Various        
			
			D/C Forms Samples
		
			 Educational Brochures    
			Emergency Plan          
			
			Emergency Release
			
			 
			Fall Tools                          
			Face to Face  
			
			     
			 Must be incorporated to MD EHR: $ 25.00 ------------>  Face to Face EHR   
			
			Glucometer Calib.           
			Grievance                      
			HHA Plan Samples    
			
			 HHA Notes Samples      
			Homebound                   
			HME/DME Forms       
			
			 HHA Waiver Notes          Initial Report/Eval          
			Intake/Referral        
			
			 Medication Samples      Mod. Orders/V.O.           
			
			Missed Visit
			
			 MSW Forms                   
			MA Fraud Info                  MC Sec. Payor Qt  
			
			
			 NOMNC
			                          
			OT Forms                         
			Oxygen Forms/Labels
			
			Physician Orders           
			
			Photo Auth Samples        
			Phychiatric Forms      
			
			
			Pediatric Form    
			PT Forms       
			Pain Tools     
			Release Info Auth.
			
			Respiratory  
			Referal Form 
			 Recert Order 
			 Risk 
			Management Forms
			
			 SN High Tech Notes     
			Supervision Forms          
			
			SN Notes Samples   
			
			 ST Forms     
			
			Surveys Rt/Emp.      
			Transfer       
			Weekly Samples   
			
			 Wound forms Samples  
			
			SN Flow Sheet (Hrs)    
			
			
			
			
			
			
			
			
   ADMISSION PACKAGE: all bi-lingual forms (English-Spanish)   
			
  
  		  We have a 
	FULL sign up already ensemble, like a "BOOKLET", 
	ready for your admission nurses, don't loose time sorting your forms, adding 
	labels, folders, etc......OUR SIGN UP PACKAGE IS READY TO USE.
	 
			
  EVERY NEEDED FORM INCLUDED, 
	at only: (minimum order 25)
			
  		    $ 5.00 the full package   or   $ 
			4.75 HMO, Non Skilled, Nurse Registry versions
			
			    
			
  
  Also we have ready: 
	Discharge 
	Packages.............. $ 3.75 each
			
  
                                    
	Recertification Packages ..... $ 3.49 each
			
  Client Information Handbook:
	
	with 
	all Patient's Information/educational needs 
	(English-Spanish ready)
			
  		    $ 3.75 each minimal order 25
			
  Customized Sign Up Folders: Designed with your Company's Logo, phone 
	and address, all labels needed including: Allergies, Abuse/Hot line Info, 
	Universal Precautions, Accreditation Info, hours of operation, etc....... $ 
			2.25 each
			
   
      
  
  
			
   
			
   
			
  		   
			
  		   
			
  		  We have all 
	Admission Forms:
			
  * Aide Assignment   * Grievance Procedures   * Emergency/Disaster Form
  
  * Appointment of Representative   * Abuse/Abuso   * Advance Directives
  
  * Nutritional Screening   * Service Agreement   * Nursing Care Plan
  
  * Consent for Treatment   * Medication Schedule   * HIPAA Acknowledgment
  
  
  * Choice form   * Bill of Rights/Responsibilities    * Patient's Handbook
			
   
			
  Also all Clinical forms:
  
  * Verbal Orders    
	* Recertification Orders    
	* Reinstatement Orders
  
  * Therapy forms  PT-OT-ST    
	* Nurses notes   
	* Aide notes
  
  * Reinstatement form   * Wound forms    * 
  Respiratory Therapy forms
  
  * MSW forms   * Team communication   * Case Conference
  
  * Itineraries   * Supervision forms   * Diabetes forms, etc
			
  		  
  * Discharge Form    
	* Agreement Addendum 	* Referrals Form
			
   
			
			
			We Have Full 
			PRINTING 
  Services, with all Home Care, HME, Clinics Forms, 1, 2 or 3 part (NCR- Carbonless)
  			
  		  
    * we offer 
next day services
    * No setup fee, best prices & best services,
WE MATCH any printing prices
			
  
	
	 Patient Personal Health Record 
			Handbook..... make a small invest in a big client 
	information source, our Personal Health Record is ready (English/Spanish), for all 
			your Patient's, 
  from Hospitalization Record, Doctor's Appointment, Diagnosis, Medications, 
			Test, etc.  
			......... 
	 
	$ 2.00 each
Patient Personal Health Record 
			Handbook..... make a small invest in a big client 
	information source, our Personal Health Record is ready (English/Spanish), for all 
			your Patient's, 
  from Hospitalization Record, Doctor's Appointment, Diagnosis, Medications, 
			Test, etc.  
			......... 
	 
	$ 2.00 each    
  
  
		
  	  * to cover the every day paper supply, equipment cost, repairs increasing 
		we may add an operating fee of 7% to each invoice.