Let ACS custom print your
Custom Encounter/Superbills Forms
Available in Laser Cut Sheet
Snap Apart ( Carbonless ) and Continuous ( Pin-feed )
A professionally-designed encounter form is one of the most important communication tools a Medical Practice can use to reduce data entry and coding errors. Custom printed encounter forms are cost-effective and help to produce a streamline patient billing process. Pre-printed encounter forms are up to 70% more cost effective when compared to an encounter form printed on blank paper.
Use Your Existing Design, or Create a New Personalized Form to Meet Your Facilities Needs. Choose Your Ink Color, we can match your current ink color. Please send a sample of your existing form with order. If changes are needed please mark clearly on sample provided and we will provide a proof to you for your approval before processing your order
Encounter Form Tips
* Making use of both the front and the back of the form allows
extensive listing of codes.
* Initiate follow-up scheduling with a return appointment area.
* Use color and graphic effects to enhance your professional image.
* Print with one of our standard colors other than black or blue to clearly identify your manual entries on the form using a black or blue pen.
Laser Sheet
• Available in 1 part
• numbeing Add $25.00 per 1000
• Printed in black ink
• 8-1-2" x 11"
• Blue or Black ink
• Other inks colors available on request
• Artwork provided from customer (useable email format, camera ready, or negative)
• Delivery - 7 days after returned approved proof.
Prices are per 1000 except 500 quantity is for lot. Prices do not in include shipping.
|
Order Quantity |
500/lot |
1000 |
2,500 |
5,000 |
10,000 |
|
Laser Cut |
$157.66 |
$94.91 |
$56.39 |
$43.84 |
$38.30 |
|
Laser Cut with Back Copy |
$252.11 |
$141.92 |
$75.38 |
$53.89 |
$41.67 |
Carbonless Snap Apart Sets
• Available in 2 or 3 part sets,
• numbering Add $25.00 per 1000
• Printed in black or blue ink
• 8-1-2" x 11"
• Blue or Black ink
• Other inks colors available on request
• Artwork provided from customer (useable email format, camera ready, or negative)
• Delivery - 7 days after returned approved proof.
Prices are per 1000 except 500 quantity is for lot. Prices do not in include shipping.
|
Order Quantity |
500/lot |
1000 |
2,500 |
5,000 |
10,000 |
|
Part |
$402.82 |
$250.76 |
$153.81 |
$124.49 |
$102.51 |
|
2 Part with Back Copy |
$486.02 |
$292.72 |
$170.42 |
$128.56 |
$106.87 |
|
3 Part |
$522.02 |
$329.31 |
$224.87 |
$183.51 |
$151.07 |
|
3 Part with Back Copy |
$606.91 |
$370.85 |
$242.21 |
$186.03 |
$155.65 |
Carbonless Pin-Feed Forms
• Available in 1, 2 or 3 parts
• numbering Add $25.00 per 1000
• Printed in either blue or black ink
• 9-1-2" x 11"
• Blue or Black ink
• Other inks colors available on request
• Artwork provided from customer (useable email format, camera ready, or negative)
• Delivery - 7 days after returned approved proof.
Prices are per 1000 except 500 quantity is for lot. Prices do not in include shipping.
|
Order Quantity |
500/lot |
1000 |
2,500 |
5,000 |
10,000 |
|
1 Part |
$255.00 |
$140.00 |
$79.00 |
$69.00 |
$49.00 |
|
1 Part with Back Copy |
$405.00 |
$216.00 |
$105.00 |
$79.00 |
$69.00 |
|
2 Part |
$385.00 |
$238.00 |
$165.00 |
$135.00 |
$115.00 |
|
2 Part with Back Copy |
$540.00 |
$317.00 |
$185.00 |
$149.00 |
$125.00 |
|
3 Part |
$499.00 |
$315.00 |
$215.00 |
$185.00 |
$155.00 |
|
3 Part with Back Copy |
$636.00 |
$395.00 |
$248.00 |
$195.00 |
$169.00 |
Prices do not include shipping charges.
|
