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Assisted Living Physicians Telephone Order 3-Part

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1 – 4$80.20
5 – 9$70.10
10 – 14$60.10
15 +$49.70
SKU: 1204

Briggs telephone orders provide a complete system for documenting physicians orders take over the phone. Simply record the doctors message on the form, and route copies as instructed:

·       ORIGINAL COPY – Physician Please Sign and Return

·       DUPLICATE COPY – Destroy When Original Has Been Received and Placed In Medical Record

·       TRIPLICATE COPY – Send to Pharmacist

Once returned, the original can be positioned on a mount sheet in the chart as a permanent record.


Ask your representative today about custom imprinting this form. A quick, easy, and affordable service to personalize your form and improve efficiency!

  • 3 ½" x 7"(detached) 
  • Yellow original, color-coded copies (part 2-green, part 3-pink)
  • Black and red ink 
  • 500 per pack

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