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Printed to guide primary-care visits, this PCP screening checklist form walks providers through the required assessment points step by step, keeping in-home or in-office evaluations organized, complete, and consistent.
The 8 x 10 inch white sheets give staff room to record findings clearly for the chart. Available in the pack quantities shown below.
| Specification | Detail |
|---|---|
| Manufacturer | Signify Health |
| Brand | Signigyhealth |
| Manufacturer Part # | UHCCHKLIST |
| Application | Check List Form |
| Category | Forms |
| Color | White |
| Dimensions | 8 X 10 Inch |
| Material | Paper |
| Type | PCP Screening |
| Pack Quantity | 1 per Pack |
| Shipping Dimensions | 8.5 × 1 × 11 in |
| Shipping Weight | 2.52 lb |
Select your preferred option from the dropdown above. Each option matches the configuration described in this section.
| Option | SKU |
|---|---|
| 1 Pack | UHCCHKLISTPK |
| Case of 12 | UHCCHKLISTCS |
