DFL Enterprises - Your Best and Fastest Source for Medical Office Forms and Supplies

CLAIM FORMS STARTING AT $19.99

We Have the Newest Revision of CMS-1500 FORMS (STARTING AT $19.99)
We Have the New UB-04 CLAIM FORMS (STARTING AT $19.99)

CMS/HCFA-1500 (NEW VERSION)
New! Newest Revision of CMS-1500 forms
laser cut sheets
New! Newest Revision of CMS-1500 forms
continuous forms
New! Newest Revision of CMS-1500 forms
snapout forms

CMS/HCFA-1500 (OLD VERSION)
laser cut sheets (with bar code)
laser cut sheets (without bar code)
continuous forms 1 part (with bar code)
continuous forms 1 part (without bar code)
continuous forms 2 part (with bar code)
continuous forms 2 part (without bar code)
snapout forms (with bar code)

UB-04 CLAIM FORMS
New! UB-04 claim forms
laser cut sheets
New! NUB-04 claim forms
continuous forms

UB-92/CMS-1450/HCFA-1450
laser cut sheets
continuous forms

HOME HEALTH CARE FORMS
CMS-485 continuous forms
CMS-486 continuous forms
CMS-487 continuous forms

Claim Form Envelopes
for HCFA-1500, CMS-1500
UB04 & UB 92 claim forms

Dental X-Ray Envelopes

Patient Valuables Envelopes

Physician's Order Sheets DPO3
Physician's Order Sheets DPO4
Physician's Order Sheets DPO5

Drug Administration Records
with Pharmacy Receipts
(DNC10)
Drug Administration Records
with Pharmacy Receipts
(DNC25)

Controlled Drug Administration Records
(D150-10)
Controlled Drug Administration Records
(D150-25)
Controlled Drug Administration Records
(D250-10)
Controlled Drug Administration Records
(D250-25)

HIPAA Information

HIPAA Compliant Confidential Patient Sign-In Systems
(HIP01)

HIPAA Compliant Confidential Patient Sign-In System with adhesive strips
(HIP02)

Confidential Sign-In Logs (Generic)
(HIP03)

HIPAA Employee Training Record
(Form #101)

HIPAA Practice Training Record
(Form #102)

Protected Health Information (PHI) Access Log
(Form #103)

Protected Health Information (PHI) Disclosure Log
(Form #104)

Patient Request for Amendment of Health Information
(Form #105)

Patient Requests for Accounting of Disclosures
(Form # 106)

Patient Request to Inspect/Review PHI
(Form #107)

Patient Request for Confidential Communications
(Form #108)

Patient Request for Restrictions on Use & Disclosure of PHI
(Form #109)

PHI Tracking Log
(Form #110)

Authorization to Release Information
(Form #111)

Notice of Privacy Practices
(Form #120)

HIPAA compliant Notice of Privacy Practices in Spanish.
(HIP120S)

Physician's Telephone Orders (DTO4)
Physician's Telephone Messages (DTM-4)
Laboratory Reports (DC5)
Laboratory Reports (DD5)
Laboratory Reports (DVT3)
Laboratory Reports (DVT5)
Laboratory Reports (DVT13)
Laboratory Reports (DVT5)
Laboratory Reports (DH3)
Laboratory Reports (DH5)

ALL OUR FORMS ARE OF THE HIGHEST QUALITY, ARE PRINTED IN STRICT COMPLIANCE WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE INSURANCE INDUSTRY.
The American HCFA Forms division of DFL Enterprises, Inc. is an independent supplier of US Government approved claim forms and NOT an affiliate of CMS ( www.cms.gov)


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IF YOU HAVE ANY QUESTIONS OR TO ORDER BY PHONE
CONTACT US TOLL FREE AT:
1-877-840-1500
FAX: 1-985-809-5788
Our Office Hours are:
Monday - Thursday: 8am - 5pm CST
Friday: 8am - 12 noon CST

or EMAIL US

AMERICAN HCFA FORMS is a Division of

124 Pine Oak Dr., Covington, LA 70433
PHONE: 985-875-0800
FAX: 1-985-809-5788

Associated sites:
AmericanHCFAForms.com | hcfa1500forms.com | claimformsdepot.com
HIPAASignIn.com | ub92.net | discountclaimforms.com