F203-I - Truth-in-lending, with imprint

This form meets federal guidelines for disclosure. Records fees, finance charges and responsibilities. 2-ply, 2-sided, carbonless form. Give the signed statement to your patient and file the duplicate in the patient's chart.

Each package contains 250 sheets.

There is a $70.00 fee for new imprint set-ups, existing imprint revisions and type resets.