Ancom has designed and printed over 1,000 custom professional forms for our customers, including the Healthcare industry, whose offices have relied on our stock professional forms for years. At Ancom, you’ll find the ready-made forms that you need: HIPAA forms, HCFA forms, ADA forms, and Rx pads, along with X-Ray mailers, recall postcards, laser statements and mailing envelopes. To get started on designing your own custom professional form, see our Custom Forms section.
NLCFUB041 Claim Form - Laser
New Format: One Part Laser Hospital Form with space for NPI code, 8 1/2" W x 11" H, OCR red ink on 20# white paper, 2500 per carton. Replaces NLCFUB921.
National Provider Identifier (NPI) codes now required. Save time by pre-imprinting the doctor's name and NPI number on the forms. Envelopes available.
Ancom Business Products an InHealth Company