Page 47 - Home Health Marketing

P.O. Box 3001 | Brentwood, TN 37024
1-800-843-9178 | medforms.com

We are pleased that you have decided to incorporate MedForms’ Patient Admission Booklet into your
homecare program. We look forward to working with you during the drafting process and developing a custom
booklet that will meet your agency’s needs and streamline the admission process for patient and clinician.
Please fill out the online form and submit along with the one-time setup fee
(payable online via Visa, MasterCard or Discover or via check made payable to MedForms mailed to:
MedForms
Attn: Development Team
P.O. Box 3001
Brentwood, TN 37024
Please note that we need your agency logo in a vector file (these files end with “.eps” or “.ai”) with PMS ink
color specifications and branding standards (if applicable).

Once your materials are received, our Development Team will begin drafting your custom patient
admission booklet. It takes approximately three to four weeks to develop the first draft.
Once you receive the first draft and have had the opportunity to review it, we ask that you provide all
changes to us in writing via email. We will make the changes you request and send a revised draft back to you
(typically within 3-4 business days). Please note that we have a three draft maximum and a final draft
approval timeline not to exceed 6 months. Once we receive final approval from you, we will begin the
printing process, and you should receive them in 2-3 weeks.
For additional questions, please call us at 1-800-843-9178

The pricing below is based on the specifications of a 64-page book. Please note that your custom book
may have an increased or decreased page count based on your individual agency’s needs. After your
custom booklet is developed, we will provide you with a quote based on your custom book’s specifications
(page count, carbonless forms, etc.). We recommend ordering a 6-month supply of books so that your
agency is receiving consistent regulatory updates.

Quantity Custom Book Additional Pages Carbonless Forms Initial Setup
10,000 - 15,000 $3.40/book $.030 x 4 pgs = 14¢ 16¢/set n/c
7,500 - 9,999 $3.59/book $.033 x 4 pgs = 15¢ 16¢/set n/c
5,000 - 7,499 $3.94/book $.040 x 4 pgs = 18¢ 17¢/set n/c
2,500 - 4,999 $4.11/book $.040 x 4 pgs = 18¢ 18¢/set $ 450.00
1,000 - 2,499 $4.87/book $.053 x 4 pgs = 23¢ 20¢/set $ 450.00
500 - 999 $5.38/book $.053 x 4 pgs = 23¢ 22¢/set $ 450.00
150 - 249 $6.16/book $.053 x 4 pgs = 23¢ 24¢/set $ 450.00
50 - 149 $6.26/book $.053 x 4 pgs = 23¢ 24¢/set $ 450.00

Initial Setup Fee: This is a one-time fee based on quantity of books printed with initial order.
Carbonless Forms: Carbonless forms can be added to your custom book for an additional charge.
Three-part forms are also available.