CLINICAL FORMS EXAM & RECORD FORMS PROGRESS AND SUPPLEMENTAL NOTES * Maintain accurate records of case details and treatment * 2-sided format allows easy reading of form while attached to chart * 2-hole punch (except 368-1177) * 81⁄2"W x 11"H MEDICAL ALERT SINGLE-SHEET FORMS Progress, Buff Paper With 2-hole Punch (367-4645)�����������������������������������������������������������250 per Pkg. 4 Pkg.@ * Ruled front and back for documenting exam and treatment notes * 2-sided * 81⁄2"W x 11"H (367-7527)�������������������������������������������������������������50 per Pkg. 4 Pkg.@ 28.99 26.99 43.99 41.99 DENTAL SERVICES RENDERED FORM * 2-sided forms printed on a sturdy, 7 pt. return postcard * 81⁄2"W x 11"H (341-5476)�����������������������������������������������������������100 per Pkg. Progress, White Paper With 2-hole Punch (367-4665)�����������������������������������������������������������250 per Pkg. 18.99 56.99 DENTAL EXAM RECORD FORM Supplemental, Green Ink With 2-hole Punch (367-7523)�����������������������������������������������������������250 per Pkg. 4 Pkg.@ Supplemental, Black Ink (368-1177)����������������������������������������������������������� 250 per Pkg. 4 Pkg.@ 138 * Printed with green ink on 80 Lb. offset opaque stock * Made from 20% postconsumer recycled content * 81⁄2"W x 11"H horizontal 45.99 43.99 45.99 43.99 80 Lb. Offset Opaque Stock (369-0032) ����������������������������������������������������������� 100 per Pkg. 5 Pkg.@ 20.99 18.99 SANFORD CHECKPOINT® RED & BLUE PENCIL * One half of the pencil is red and the other half is blue * Great for identifying and labeling patient charts (528-0000)��������������������������������������������������������������12 per Box 5.99 To order, visit: www.henryscheindental.com 20DC2250_Clinical_Forms_p134-148 copy_cjb.indd 138 3/13/20 3:35 PMhttp://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3681177%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3681177 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3677527%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3677527 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3674645%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3674645 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3415476%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3415476 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3674665%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3674665 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3677523%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3677523 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3690032%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3690032 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3681177%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D3681177 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D5280000%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20202021%26utm_term%3D5280000 http://www.henryscheindental.com