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Patient consent forms.

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1574 Pads of 100 0.000  Consent - Allergy Immunotherapy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8331 Pads of 100 0.000  Consent - Amniocentesis SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3421 Pads of 100 0.000  Consent - Argon Laser Trabeculoplasty SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1931 Packs of 50 6.940  Consent - Autopsy & Disposition of Fetus SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 3 Pt NCR W/C/P  Printed on demand  Pathology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1742 Each 0.460  Consent - Autopsy &tc Body of Newborn SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt NCR, 5 HP,Collate  Printed on demand  Labor and Delivery PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1693 Pads of 100 0.000  Consent - Candela Vascular Laser Surgery SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue Bond, Pads/100, 5 HP  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3394 Pads of 100 0.000  Consent - Chalizion SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3724 Each 0.000  Consent - Chemotherapy for Malignant Disease SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP, Collate, No Staple  Printed on demand  Cancer Clinic Infusion Room PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3391 Pads of 100 0.000  Consent - CryoTherapy of the Eyelashes SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3413 Pads of 100 0.000  Consent - Diode Laser Cyclophotocoagulation SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2208 Pads of 100 0.000  Consent - Direct Current Countershock Cardioversion SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue Bond, 5 HP, Do Not Pad  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3451 Pads of 100 0.000  Consent - Dobutamine Stress Echocardiogram SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond 100/pd 5HP  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 7279 Pads of 100 0.000  Consent - E.R.C.P. (Endocopic Retrograde Cholangiopancreatogra SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond???  Printed on demand   PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2206 Pads of 100 0.000  Consent - Electrophysiology Study SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue Bond, 5 HP, Do Not Pad  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8334 Pads of 100 0.000  Consent - Electrophysiology Study & Radiofreq Ablation SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4985 Pads of 100 0.000  Consent - Excision SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100  Printed on demand  Shelbyville Derm Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0731 Packs of 50 4.900  Consent - Exercise Testing SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt NCR, 5 HP  Printed on demand  Health Promotion Center PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1796 Pads of 100 0.000  Consent - Exercise Testing SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, Pads/100  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5836 Pads of 100 0.000  Consent - Fine Needle Aspiration SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Canary Bond, Pads/100  Printed on demand  Pathology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2281 Pads of 100 0.000  Consent - Flash Lamp Pulsed Dye Laser Procedure SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3403 Pads of 100 0.000  Consent - Fluorescein Angiography SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3402 Pads of 100 0.000  Consent - Focal Laser SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2283 Pads of 100 0.000  Consent - Glycolic Acid Peel to Face SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0509 Packs of 50 5.220  Consent - Immunization (Peds) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11.5 2 pt NCR, 5 HP  Kept in stock  CHOC PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3721 Packs of 50 4.900  Consent - Immunization (Peds) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt NCR, 5 HP  Printed on demand  University Pediatrics PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2824 Pads of 100 0.000  Consent - Informed Consent for Breast Core Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, Pads/100  Printed on demand  Breast Imaging PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2822 Pads of 100 0.000  Consent - Informed Consent for Cyst Aspiration SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, Pads/100  Printed on demand  Breast Imaging PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3398 Pads of 100 0.000  Consent - Injection of Verteporfin Dye w Photodynamic Th Laser SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2903 Pads of 100 0.000  Consent - Inpatient Transport to Outside Facility SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 ??????????????  Printed on demand  Patient Care Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2203 Pads of 100 0.000  Consent - Insertion of Pacemaker SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue Bond, 5 HP, Do Not Pad  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1566 Pads of 100 0.000  Consent - Intradermal Skin Testing SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP, Do Not Pad  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1137 Pads of 100 0.000  Consent - Intradermal Test & Desensitization SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond F & B 5HP  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4189 Pads of 100 0.000  Consent - Laparoscopic IPAA SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue, F&B, 5 HP, Pads?????  Printed on demand  Colon and Rectal Surgery PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3411 Pads of 100 0.000  Consent - Laser Suture Lysis SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3412 Pads of 100 0.000  Consent - LPI SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8332 Pads of 100 0.000  Consent - Lumbar Puncture for Suspected Meningitis SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0999 Pads of 100 0.000  Consent - Oral Challenge with Food Additive SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1568 Pads of 100 0.000  Consent - Oral Challenge with Food Additive SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP, Do Not Pad  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3401 Pads of 100 0.000  Consent - Pan Retinal Photocoagulation SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4190 Pads of 100 0.000  Consent - Partial Colectomy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue, F&B, 5 HP, Pads?????  Printed on demand  Colon and Rectal Surgery PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2453 Pads of 100 0.000  Consent - Patient Transfer Consent SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 Pt NCR W/C  Printed on demand  Emergency PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0301 Pads of 100 0.000  Consent - Pediatric SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand   PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6267 Pads of 100 0.000  Consent - Pelvic Floor Rehabilitation Therapy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, Pads/100, 5 HP  Printed on demand  Outpatient Rehabilitation Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1203 Pads of 100 0.000  Consent - Perform Autopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond 100/pd F & B 5HP  Printed on demand  Pathology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0027 Pads of 100 0.000  Consent - Periodic Treatment SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP  Printed on demand  Ambulatory Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1092 Packs of 50 0.000  Consent - Phototherapy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt NCR, 5 HP  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5279 Pads of 100 0.000  Consent - Placement of Peripherally Inserted Central Catheter SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue???????  Printed on demand  PICC PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1224 Pads of 100 4.870  Consent - Port Wine Stain removal SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue 20#, 5 HP, DO NOT PAD  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2046 Pads of 100 0.000  Consent - Pregnancy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP, Pads/100  Printed on demand  Radiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4928 Pads of 100 0.000  Consent - Punch Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, Pads/100, 5 HP  Printed on demand  Dermatology/Shelbyville PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3395 Pads of 100 0.000  Consent - Punctal Cautery SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1073 Packs of 50 0.000  Consent - Radiation Therapy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 Pt NCR 5HP  Printed on demand  Radiation Therapy PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4594 Pads of 100 0.000  Consent - Radiology Pregnancy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, F&B, Pad/100  Printed on demand  Page-Campbell Heart Institute PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3857 Pads of 100 0.000  Consent - Refusal for Post-Exposure Prophylasix SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3879 Pads of 100 0.000  Consent - Refusal for Postexposure Prophylaxis SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 E-docs  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5080 Each 0.000  Consent - Release of Liability SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP, Do Not Pad  Printed on demand  VCH Administration PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1708 Each 0.000  Consent - Research Study SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 11 x 17 Reg bond, F&B, Fold  Printed on demand  Pediatric Infectious Diseases PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6381 Packs of 50 0.000  Consent - Sedation - VCH SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt (w/c), 5 HP  Printed on demand  Pediatric Emergency Room PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0692 Pads of 100 0.000  Consent - Sterilization SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond  Printed on demand  OB/GYN PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1118 Pads of 100 0.000  Consent - Stress Testing SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11  Printed on demand  Page Campbell Heart Institute PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2277 Pads of 100 0.000  Consent - Stress Testing SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11  Printed on demand  Page-Campbell Heart Institute PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3392 Pads of 100 0.000  Consent - Tarsorrhaphy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1575 Pads of 100 0.000  Consent - Testing & Desen to Hymenoptera Ven SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1562 Pads of 100 0.000  Consent - Testing to Drugs, Dyes SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, 5 HP  Printed on demand  Allergy Clinic PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6395 Pads of 100 0.000  Consent - To Dermatology Treatment (Various) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3449 Pads of 100 0.000  Consent - Transesophageal Echocardiography SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond 100/pd 5HP  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

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 PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO YES NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0874 Packs of 50 7.310  Consent - Transport and Medical Trtmnt - Adult SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, Canary, Pink NCR  Kept in stock  LifeFlight PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

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 PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE YES NO NO NO NO NO NO NO YES NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0362 Pads of 100 0.000  Consent - Use of Pat Owned Hlth Eq SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x11 Reg Bond  Printed on demand  Nursing PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1223 Pads of 100 0.000  Consent - Wart Removal (Candella, Vasc., Laser Surg) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue 20#, 5 HP, DO NOT PAD  Printed on demand  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1553 Pads of 100 0.000  Consent - Wellness Center SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond 2 pgs, F&B  Printed on demand  Health Plus PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1728 Pads of 100 0.000  Consent - Wireless Capsule Endoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue 20#, 5 HP, DO NOT PAD  Printed on demand  GI/Endoscopy PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 1126 Packs of 50 0.000  Consent - Women's (MRI) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 2 pt NCR, 5 HP  Printed on demand  Radiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3409 Pads of 100 0.000  Consent - YAG Capsulotomy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 3404 Pads of 100 0.000  Consent - YAG Vitreolysis SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, DO NOT PAD  Printed on demand  Ophthalmology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 2192 Pads of 100 0.000  Consent and Waiver of Liability SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Tamper Resistant Paper, Pads of 100  Printed on demand  Graduate Medical Education PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6383 Pads of 100 0.000  Consent for Transfusion of Blood/Blood Products (VCH) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue 20#, F&B, Pads/100, 5 HP  Printed on demand  NICU (VCH) PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6360 Pads of 100 9.390  Consent for Treatment and Agreement to Pay (Adult) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11.5 Reg Bond, 5 HP, Do Not Pad  Kept in stock  VMG Adminstration PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6427 Pads of 100 8.820  Consent for Treatment and Agreement to Pay (Pediatric) SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11.5 Reg Bond, 5 HP, Do Not Pad  Printed on demand  VMG Administration PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9208 Pads of 100 0.000  Consent to Cardiac Catheterization SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9209 Pads of 100 0.000  Consent to Cardiac Catheterization with Angioplasty and Stent SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9210 Pads of 100 0.000  Consent to Cardiac Catheterization with Angioplasty and/or Val SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9211 Pads of 100 0.000  Consent to Cardiac Catheterization with Cardiac Defect Occlusi SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8335 Pads of 100 0.000  Consent to Cardiac Procedure SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9223 Pads of 100 0.000  Consent to Cesarean Section SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Reg Bond, F&B  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9214 Pads of 100 0.000  Consent to Colonoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9216 Pads of 100 0.000  Consent to Colonoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9213 Pads of 100 0.000  Consent to Congenital Cardiac Surgery SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8339 Pads of 100 0.000  Consent to Cryosurgery - Liquid Nitrogen SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9222 Pads of 100 0.000  Consent to Dermatology Procedure SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9204 Pads of 100 0.000  Consent to Direct Current Countershock Cardioversion SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8340 Pads of 100 0.000  Consent to Electrodessication Curettage Skin Lesion SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8341 Pads of 100 0.000  Consent to Incision Drainage Cyst SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  System Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9207 Pads of 100 0.000  Consent to Insertion of Pacemaker / Internal Cardiac Defibrill SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9202 Pads of 100 0.000  Consent to Intrauterine Insemination SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6010 Pads of 100 0.000  Consent to Operate - Central Venous/Pulmonary Artery Cath SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100????????  Printed on demand  SICU PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6009 Pads of 100 0.000  Consent to Operate - Fiberoptic Bronchoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100????????  Printed on demand  SICU PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6011 Pads of 100 0.000  Consent to Operate - Percutaneous Esophagogastrostomy tube SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100????????  Printed on demand  SICU PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 6012 Pads of 100 0.000  Consent to Operate - Recurrent Exploratory Celiotomy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue, 5 HP, Pads/100????????  Printed on demand  SICU PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5159 Pads of 100 0.000  Consent to Operation - Card Cath & Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, Pads/100  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5157 Pads of 100 0.000  Consent to Operation - Card Cath/ PTCA/ Stent SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP, Pads/100  Kept in stock  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0680 Pads of 100 0.000  Consent to Operation - Colonoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, Pads/100  Kept in stock  Endoscopy Lab PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0527 Pads of 100 0.000  Consent to Operation - Dermatology Procedures SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Light Blue Bond, 5 HP, Do Not Pad  Kept in stock  Dermatology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 5158 Pads of 100 0.000  Consent to Operation - Right Heart Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, 5 HP,  Printed on demand  Cardiology PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 0681 Pads of 100 0.000  Consent to Operation - Upper Gastro/Endoscopy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x11 Blue 20 lb, Pads of 100  Kept in stock  Endoscopy Lab PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 4304 Pads of 100 0.000  Consent to Operation, Treatment or Other Procedure SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: 8.5 x 11 Blue Bond, Pads/100, 5 HP  Printed on demand  Radiology - VCH PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 9217 Pads of 100 0.000  Consent to Percutaneous Liver Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT:  Printed on demand  Systems Support Services PDF avail- able? ENGLISH ARABIC CROATIAN JAPANESE KOREAN KURDISH LAOTIAN RUSSIAN SPANISH VIETNAMESE NO NO NO NO NO NO NO NO NO NO

MC# UNIT OF ISSUE: PRICE PER UNIT:  FORM TITLE: 8342 Pads of 100 0.000  Consent to Punch Biopsy SIZE: MATERIAL:  PRODUCTION METHOD:  DEPARTMENT: