| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Forms Per Page | 1 |
| Number of Entry Lines | 23 |
| Sheet Size | 8.5 x 11.63 |
| Form Size | 8.5 x 11.63 |
| Print and Ruling Color(s) | Black |
| Numbering Color(s) | Black |
| Color Family | Blue |
| Paper Color(s) | Blue |
| Principal Heading(s) | Date; Please Print Name; Arrival Time; Appt. Time; Appointment With; New Patient; Any Changes Since Last Visit |
| Copy Types | Two-Part Carbon |
| Dated/Undated | Undated |
| Special Features | Blue Sheets |
| Form Quantity (Total) | 125 |
| Form Type Details | Medical Admission |
| Format Indicator | Unbound |
| Global Product Type | Medical Admission Forms |
| Columns per Sheet | 6 |
| Product Biodegradability in Days | 0 |