Carolina Physician Records and Systems

   Encounter Forms
Encounter Forms are custom designed, or we can duplicate your current form.

     Standard Features:

Black or Reflex Blue Ink

1 Color Printing

Screens (Shading)

Reverse Printing

     Additional Features:

Multi-Color Printing

PMS Color Match

24lb Paper

Clean Edge Perforation

Backprinting

To view larger samples please click on the links below.

SAMPLE 1 - Black Ink

SAMPLE 2 - Blue Ink

SAMPLE 3 - Red Ink

SAMPLE 4 - Green Ink

SAMPLE 5 - Multi-Color

Pricing (per 1000):

	2500	5000	10,000	20,000
1 PART:	$74.15	$56.90	$34.40	$31.55
2 PART:	$110.25	$83.75	$69.10	$54.45
3 PART:	$150.80	$115.70	$101.40	$85.85

Add $50.00 for ICD-9 Diagnosis Backer (any quantity).
Free Composition and Typesetting with orders of 10,000 or more.

All of our Forms are custom designed to fit your needs. Please contact David Beasley at 1-866-363-8300 for prices and more product information.

CUSTOMER PRIVACY

At Carolina Physician Records we value our customers and their privacy. All personal information will be kept confidential and will be used only to expedite your orders, to keep you updated on your orders, and to send you information on monthly specials. We always keep this information private and confidential and it will not be disclosed or sold to any outside organization.

PAYMENT OPTIONS

Order 24 hours a day online or call us at 1-866-363-8300 Monday through Friday, 9 am to 5 pm EST.
We accept these credit cards:

MONTHLY SPECIALS

Great Savings on Forms, Charts & Labels!