Medical Laser Billing Statements
B.
A.
WE ACCEPT
Please see back of form
£ Please P box if above address information is incorrect & indicate changes on reverse side .
£ Please P box if above address information is incorrect & indicate changes on reverse side .
PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS
WLCS107-BK
PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS
WLCS108-BK
Billing Forms are the staple of any medical office. Add a little color to your statements for a more professional looking form. For more customization options , call customer service for a quote.
Features • Blue or Burgundy • 81/2" x 11" • 20 lb. White laser bond with micro-perforation for ease of printing, opening and remittance • Change of address/insurance backprint • 500 per package • Optional: “We accept” - Mastercard/Visa - Mastercard/Visa/Discover - Mastercard/Visa/Discover/American Express backprint
Medical Laser Billing Statement
Item Number
Description
Color
500 1,000 2,500 5,000 10,000
VWH-HF13-NS24
Generic laser statement
Blue Blue Blue Blue
$39.63 $39.63 $39.63 $39.63 $39.63 $39.63 $39.63
$56.14 $56.14 $56.14 $56.14 $56.14 $56.14 $56.14
$113.93 $113.93 $113.93 $113.93 $113.93 $113.93 $113.93
$208.04 $208.04 $208.04 $208.04 $208.04 $208.04 $208.04
$411.12 $411.12 $411.12 $411.12 $411.12 $411.12 $411.12
Popular Pick! VWH-HF14-NS24 Generic laser statement (MC/VISA) Best Seller!
VWH-HF17-NS24
Generic laser statement (MC/VISA/DISC)
A. VWH-HF18-NS24 B. VWH-HF19-NS24
Generic laser statement (MC/VISA/DISC/AMEX)
Generic laser statement
Burgundy Burgundy Burgundy
VWH-HF16-NS24 VWH-HF15-NS24
Generic laser statement (MC/VISA)
Generic laser statement (MC/VISA/DISC)
(R) Production time: 1 working day. 2000 per carton.
120
Manufactured in the USA
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