Patient Management-Acupuncture

We have the forms and materials you need to manage your patients properly.

DESCRIPTION	ITEM #	PRICE
Accident History Questionnaire	004	36.00
Assignment Direct Payment	053	8.00
Counter Checks	117	12.75
Dismissal Card	126	12.75
Dismissal Letter	124	8.00
Family Health History	127	8.00
Health Care Service Agreement	384	36.00
Initial Questionnaire	952	12.75
Insurance Verification Form	2007	8.00
Missed Appointment Log	190	8.00
Office Policy Ins. Assignment	980	8.00
Oswestry Questionnaire	132	12.95
Our Patients Speak Testimonial	912	8.00
Patient Care Insurance Agreement-Counter Check	983	8.00
Patient Care Insurance Agreement-Credit Card	979	8.00
Patient Condition Assessment	162	12.95
Patient Insurance Record	991	8.00
Patient Progress Graph	669	18.00
Patient Symptom Evaluation	870	8.00
Patient's Development Report	237	8.00
Sign-In Sheet	303	15.00
Update Report	363	8.00

L.K. Graphic Communications • 1-800-548-3676