Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Blank Statement / Invoice Paper

Blank Statement / Invoice Paper

Blank Statement/Invoice Paper
Size: 8.5" x 11"
1 Part 20# Laser / Deskjet Paper.

Available options:

1) White:
Choice of 3 different clean perforation positions:. 3.00", 3 1/2" or 3 2/3" from the top for patient remittance.

2) Colors:
Choice of 3 different clean perforation positions:. 3.0", 3 1/2" or 3 2/3" from the top for patient remittance and 4 Different paper colors(Canary, Blue, Green or Pink)

3) Pre-printed with optional M/C and VISA payment information at the top with change of address backer.
The Credit Card Information is pre-printed at the top with change of address information on the back. Choose from 4 different Ink Colors.
Only available with a 3.5" perforation position

**Also available with Discover and AMEX Card Payment Options. Please call for customer service at 1.800.778.6247 for additional informtion.


Blank Statement / Invoice paper

Colored Blank Statement / Invoice paper

View Sample
PDF
Pre- printed Payment info. and change of address area on back

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