ACKNOWLEDGE RECEIPT DescriptionThis form acknowledges the receipt of notification of your privacy practices. Printed on white paper with blue ink. In pads of 100. same size as our prescription blanks, 5 1/4" x 4". This form acknowledges the receipt of notification of your privacy practices. Printed on white paper with blue ink. In pads of 100. same size as our prescription blanks, 5 1/4" x 4".
