No. 100 Registration - For all new patients.  Back has medical history for emergency treatment and charge, credit, and balance columns.

4-1/4 x 5-1/2      Pkg: 500            1/$17.66    2/$17.38 ea

No. 100S - Same as No.100 but in Spanish

No. 101 Examination Chart - Large tooth charting diagram with complete medical/dental/oral history.  Excellent for patient education. Services necessary and estimates on the back.

8-1/2 x 11        Pkg: 200        1/$15.60    3/$15.00 ea    6/$14.58 ea

No. 101 Examination Chart - Large tooth charting diagram with complete medical/dental/oral history.  Excellent for patient education. Services necessary and estimates on the back.

8-1/2 x 11        Pkg: 200        1/$15.60    3/$15.00 ea    6/$14.58 ea

No. 103 Appointment Schedules - Use one for each case.  Includes time necessary, services planned, date appointed.  Printed on both sides.

5-1/2 x8-1/2     Pkg: 200          1/$12.54     3/$12.25 ea    6/$11.38 ea

No. 104 Recall Examination Chart - Large tooth charting diagram.  Same as No. 101 but for recalls.  Use separately or place over diagram on No. 101 Examination Chart.  Services necessary and estimate on back.

5-1/2 x 8-1/2       Pkg: 200        1/$12.54    3/$12.25 ea     6/$11.38 ea

No. 105 Recall Cards - Heavyweight index card for durability.  Complete information on each recall patient.  Space for month due date, appointment date, and comments.   Use front and back.  This is a great practice building tool!

5 x 8       Pkg: 200

1/$16.82    3/$16.52 ea      6/$16.00 ea

No. 108 Treatment Schedule - Complete schedule with fee column.  Scored to fold in half to economically provide four treatment sheets for time needed, description of services to be rendered, date of appointment, and completion check column, plus the fee.

8-1/2 x 11        Pkg: 200        1/$19.32    3/$18.82 ea      6/$18.49 ea

No. 109A File Envelope - Sturdy 40# kraft stock and envelope design assures safe storage of valuable treatment records.  Headed with patient name, address, phone number, etc.   Seam sealed outside for better durability.

8-7/8 x 11-7/8       Pkg: 200     1/$34.68    3/$34.81 ea     6/$33.81 ea

No. 109B -  Same as No. 109 but with colored borders: red, blue, and green.   Excellent for identifying specific needs, i.e., red for medical alerts, blue for insurance, green for cash patients, etc.