small 8″ x 10″ $ 16.95, large 10″ x 12″ $ 19.95
$16.95 – $19.95
Disclaimer: All paper, chart and/or electronic formats and information are provided for the sole convenience of the user. HD Merrimack makes no warranties or representations about the product or the supplied forms. There may be state specific and physician signed forms the user needs to obtain, not included in the information provided. The forms provided are guidelines only. The user assumes all responsibility for use of this product, including all information the user puts on the forms and the accuracy of said information as well as any documents inserted/not inserted in this product.