Book does have some handwriting and notes in the front section of the book. However it is completely usable and most pages do not have any handwriting. This textbook titled "Workbook for Insurance Handbook for the Medical Office" is a valuable resource for anyone interested in the subject area of insurance. Published by Elsevier-Health Sciences Division in 2009, the trade paperback format comes with 568 pages of insightful content authored by Marilyn Fordney. The book is intended for intermediate learners in the field of adult and further education. The workbook has a length of 10.9 inches and a width of 8.5 inches. The language used throughout the book is English, and it covers topics such as insurance policies, medical billing, and coding procedures. The book is an exceptional learning resource for anyone seeking to improve their knowledge of insurance in the medical office. Acceptable: The book has obvious wear. It may have some damage to the cover, but its integrity is intact. The binding may be slightly damaged, but its integrity is still intact. There may be possible writing in the margins and underlining and highlighting of text, but there are no missing pages or anything that would compromise the legibility or understanding of the text. Please look at our store for unique collectibles and quality vintage items. Read our Seller Feedback and shop with confidence. See all the photos as they are part of the description and show condition . Item pictured is item that you will receive - except when item has a quantity in which item will be in similar condition to item pictured. If Box and paperwork are included with used item it will be included in the photos. Please note that color may vary due to lighting in the photos. Please ask any and all questions BEFORE purchasing. I try to describe as best as I can and all sales are AS IS. We are not experts on any items and all information is to the best of our knowledge. We do offer combined shipping on orders for multiple items. For Combined shipping simply commit to buy then request an invoice prior to making payment. Payment is expected within 5 days. You may ask for additional time otherwise order is Canceled after 5 days if not paid. Please see all photos to help determine Condition * Thank you for looking at our items!!! * We try to respond to all questions and offers as quickly as possible!! * We ship within 1 business day after the payment is received!! * We are always looking for new items each day to list so be sure to follow our store as listings are updated daily!! * Condition of items are based on our opinions!! High Value items will be shipped insured and may require signature on delivery. MR BS 1