Physicians Telephone Orders Mount Form
Features three individual snap-out-style telephone orders per 8 1/2" x 11" page with an 8 1/2" x 11" mount sheet attached. Routing is as follows:
· ORIGINAL COPY - Physician Please Sign and Return
· PHARMACY COPY - Send to Pharmacy
· CHART CONTROL COPY - Attach Original Signed Copy When Received
When the physician has signed and returned the order, this original copy is mounted on the chart control which features pressure-sensitive tape for mounting purposes. All detachable parts are perforated between the three telephone order forms for easy individual removal.
Ask your representative today about custom imprinting this form. A quick, easy, and affordable service to personalize your form and improve efficiency!
• Each slip measures 8 1/2" x 3 1/4"
• printed in black and red ink on carbonless paper
• white original, color-coded copies and canary mount sheets
• packaged in 125s