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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2312 Packs of 50 4.590 ABN Instructions / Medicare & Lab Tests

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 2 pt NCR (w/c) Printed on demand VMG Administration

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able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2311 Packs of 50 4.620 ABN Instructions / Medicare May Not Pay

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 2 pt NCR (w/c) Printed on demand VMG Adminisatration

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2309 Pads of 100 4.200 ABN Instructions / Medicare Will Not Pay

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Front Only, Do Not Pad Printed on demand VMG Administration

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2603 Pads of 100 4.430 Additional Pay Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 white/pad 100 Printed on demand PeopleSoft/HR

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2811 Pads of 100 4.480 Ambulance Transport/Medical Necessity

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand 11 South

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3916 Pads of 100 8.870 Authorization for Release of Medical Info

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, F&B, Pads/100 Kept in stock Medical Information Services

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able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3930 Pads of 100 4.900 Authorization to Create, Use or Disclose Photos/Videos

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Blue Bond, 5 HP, Pads/100, One sided Kept in stock Patient Care Services

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able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2644 Pads of 100 4.250 Bed Ready Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond 100/pd Printed on demand Environmental Services

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3834 Pads of 100 8.610 Code Status Progress Note

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, F&B, 5HP Printed on demand Nursing

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2285 Pads of 100 0.000 Consent - Transfusion of Blood/Blood Products

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Blue Bond, 5 HP, Do Not Pad Kept in stock Patient Care Services

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avail-
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NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

4320 Pads of 100 8.880 Consent - Trtmnt & Author. for Rel of Info

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond 100/pk, F & B, 5HP Kept in stock Admitting

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able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0201 Pads of 100 0.000 Consent to Surgical, Medical, Radiological or Other Procedures

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Blue, 5 HP, Pads/100 Kept in stock Accreditation & Standards

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able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3636 Each 0.040 Construction/Infection Control Permit

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Do Not Pad Printed on demand Accreditation and Standards

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0740 Each 0.000 Discontinue - Signature Authorization (Automated)

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Loose f&b Printed on demand Financial Management

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3769 Pads of 100 8.610 Dr.'s Ord. to Limit Cardiopulmonary Resuscit

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, F&B, 5 HP Printed on demand Nursing

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2222 Pads of 100 4.200 EEG Log

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Neurodiagnostics

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2606 Pads of 100 9.460 Employee Information/Paycheck Dist. Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 blue/pad 100/f/b Printed on demand PeopleSoft/HR

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2300 Pads of 100 4.130 Floor Plan - Pediatric ICU

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Pediatrics

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2001 Pads of 100 4.130 Floor Plan - SICU & Cardiac Recovery

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand SKU & C.R.

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0723 Pads of 100 4.380 Forms Questionnaire & Record of Committee Act

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond pad 100 Printed on demand Forms Management

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0877 Pads of 100 8.880 Growth Record For Infants

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond f & b 5 H.P. Printed on demand Pediatrics

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

4226 Each 0.040 Heart Healthy Cookbooks

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Loose Printed on demand Nutrition Clinic

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2223 Each 0.080 High Calorie/High Protein Diet

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, F&B, Do Not Pad Printed on demand Diet Clinic

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2740 Each 0.290 HIPAA - Notice of Privacy Practices

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Front & Back Kept in stock All Departments

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2832 Pads of 100 4.430 HIPAA - Notice of Privacy Practices Acknwldgmt

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, 5 HP, DO NOT PAD Kept in stock All Departments

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1239 Pads of 100 4.430 Home Department Change Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 White/pad 100 Printed on demand PeopleSoft/HR

PDF
avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0650 Pads of 100 4.130 I.V. Therapy Worksheet

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Nursing

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2608 Pads of 100 4.430 ID Card Authorization Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand PeopleSoft/HR

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0136 Pads of 100 1.350 Isolation Quick Reference Cards

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

5 x 8 28# White "Color Print Paper";T;F;F; Printed on demand Infection Control

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO YES NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

6002 Pads of 100 8.880 Low Sodium-High Potassium Food List

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Nutrition Services

PDF
avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0608 Pads of 100 4.430 Map To Hospitality House

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Pink Bond, Pads/100 Kept in stock Patient Affairs

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2103 Pads of 100 4.870 Map/Tunnel to Roundwing

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 X 11 Light Blue, Pads/100, Printed on demand Pt. Affairs

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1394 Pads of 100 4.710 MRI ER / Inpatient Screening Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100, 5 HP Printed on demand Radiology

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2576 Pads of 100 4.150 Mycobacteriology Worksheet

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Do Not Pad Printed on demand Clinical Bacteriology

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5775 Pads of 100 4.430 Neonatal Growth Chart

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, 5 HP Printed on demand NICU

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2602 Pads of 100 4.430 New Hire Personnel Action Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg bond/pad 100 Printed on demand PeopleSoft/HR

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5682 Pads of 100 4.430 Non-Payroll Hours Worked/Nursing

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand Nursing Registry

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1359 Pads of 100 0.000 Notifiable Disease Case Report

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

Printed on demand Infection Surveillance

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5971 Pads of 100 4.430 O.P. Daily Cash Collection

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand VMG Administration

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5281 Pads of 100 4.410 Off Hours Visitor Log/Pt. Units

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand Patient Care Services

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0445 Pads of 100 4.480 Oral Contrast Media Prescription

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Regular Bond, Pads/100 Printed on demand Pharmacy (VMG Administration)

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2140 Pads of 100 8.510 Orthopaedic Report Sheet

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, f&b, Printed on demand Orthopaedics (11 No.)

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

3007 Pads of 100 4.430 Pain Information Drawings

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg bond, Pads/100 Printed on demand Orthopaedics

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0983 Pads of 100 9.280 Parents Guidelines For Sup Your O/W Child

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 X 11 Regular bond F/B Printed on demand Nutrition Services

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1955 Pads of 100 4.150 Patient Comments (Cancer Clinic)

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, DO NOT PAD Printed on demand Cancer Clinic

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0840 Each 0.400 Patient Financial Assistance Program - Brochure

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 4.25 White Cardstock, F&B, FULL COLOR Printed on demand VMG Administration

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0875 Each 0.750 Patient Financial Assistance Program - Poster

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

11 x 17 Glossy, FULL COLOR Printed on demand VMG Administration

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0899 Pads of 100 4.190 Patient Information

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Urology

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0664 Pads of 100 5.170 Patient Information

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Orchid, 5 HP, Pads/100 Printed on demand Plastic Surgery

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

NO NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2341 Pads of 100 4.440 Patient Information

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond Printed on demand Oncology Clinic

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1335 Pads of 100 4.620 Patient Rights and Responsibilities Brochure

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Ivory, Single Sided, Do Not Pad Kept in stock Quality Assurance

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO YES NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1238 Pads of 100 4.430 Payroll Check Distribution Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 white/pad 100 Printed on demand PeopleSoft/HR

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2151 Pads of 100 4.150 Pediatric Information Sheet

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, DO NOT PAD Printed on demand Orthopaedics

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avail-
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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2601 Pads of 100 4.430 Personnel Action Form (PAF)

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 white/pad 100 Printed on demand PeopleSoft/HR

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

1352 Pads of 100 0.000 Pertussis/Meningococcal Surveillance

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

Printed on demand Infection Surveillance

PDF
avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

0295 Pads of 100 8.680 Position Control Form/Nursing

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100, F&B Kept in stock Nursing

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YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

2605 Pads of 100 4.430 Position Management Form

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 white/pad 100 Printed on demand PeopleSoft/HR

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5275 Pads of 100 4.410 Pre-Procedure Checklist

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, Pads/100 Printed on demand Cardiac Care Unit

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avail-
able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE

YES NO NO NO NO NO NO NO NO NO

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MC# UNIT OF ISSUE: PRICE PER UNIT: FORM TITLE:

5912 Each 0.230 Psychiatric Examination

SIZE: MATERIAL: PRODUCTION METHOD: DEPARTMENT:

8.5 x 11 Reg Bond, 5 HP Printed on demand Psychiatry

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DISPLAYED ON: 11-23-09
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