Sign-In Forms

Call 800-4WILMER (800-494-5637) Click here to sign up for email invoice

  • image
  • image
  • image
  • image
  • image
Wilmer has the confidential patient sign-in form for any location. Offered in small quantities, and with more sign-in lines than the competition.
contact salesperson about this product

Additional Details

Wilmer's offering of patient sign-in forms has been growing over the years. We have two versions available: label form or the 3-part pegboard form.

The label sign-in comes in an English version in blue (our largest seller), burgundy or green, 125 per package, 25 lines per sheet. The English/Spanish label sign-in version is offered in blue, 125 per package, 25 lines per sheet. The patient signs their name on the line, taking the number next to their name if the office uses this to call patients back, and the office peels back the label with the patients name on it so that future patients signing in do not see the name of previous patients seen that day. The office may use the label to add to the patient file or workflow tracking system, or discard it all together. The words "please use next line" will show once the label has been peeled off the original form. (see the blue form in the multiple image above) This will aid the patients in signing on the correct line.

The 3-part form comes with a pegboard, journal and signature slips in white. (refill signature slips also available) Each patient signs their name on a numbered slip and then removes it. This number is how they will be called back to see the doctor. The patients name is hidden and protected by the carbonless paper from other patients viewing it when signing in.

Also note our non-patient related sign-in form for other entities use, such as attorney's and banks/credit unions.

To see our complete listing of Sign-In sheets and other HIPAA forms, see our Compatible filing catalog, or call Customer Service and request your copy of the W-CFP-CAT. (Available with and without the net price list)

More Resources

Sign-In Form Flyer
Healthcare Products Flyer
How to Use Sign-In System