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Prescription Pads

Prescription Pads

Pacific Printing Company has just what you've ordered! Security Prescription Pads that meet & exceed all California requirements.Competitive pricing.Fast – often same-day – turnaround!

Three easy ways to order:

  • Complete the online order form
  • Call us at (800) 640-0992
  • Complete the paper order form - printed version & fax you order

Standard-Size pads with up to 3 Medications. See below.

Download Order Form and Price List

Single-Part Pads

1

Description:

100 Security forms per pad. Size of pad: 4" x 5" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Up to five prescribers and/or locations may be included in the imprint area at top of form. Refer to the price list for current pricing and ordering increments.

Size:

4" x 5"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

1PS1

2

Description:

100 Security forms per pad. Size of pad: 4" x 5" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Up to five prescribers and/or locations may be included in the imprint area at top of form. Refer to the price list for current pricing and ordering increments.

Size:

4" x 5"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

3PT1

3

Description:

100 Security forms per pad. Size of pad: 5" x 7" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Use this style when prescribing multiple drugs (up to three per script). Up to eight prescribers and/or locations may be included in the imprint area at top of form. Refer to the price list for current pricing and ordering increments.

Size:

5" x 7"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

PL1

Two-Part Pads

1

Description:

50 Security forms per pad. Size of pad: 4" x 5" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Up to five prescribers and/or locations may be included in the imprint area at top of form. Second part transfers the information you write (patient name, DOB, medication prescribed, etc.) from the top copy. No other printing on part two. Refer to the price list for current pricing and ordering increments.

Size:

4" x 5"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

2PS2

2

Description:

50 Security forms per pad. Size of pad: 4" x 5" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Up to five prescribers and/or locations may be included in the imprint area at top of form. Second part transfers the information you write (patient name, DOB, medication prescribed, etc.) from the top copy. No other printing on part two. Refer to the price list for current pricing and ordering increments.

Size:

4" x 5"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

4PT2

3

Description:

50 Security forms per pad. Size of pad: 5" x 7" Exceeds California Department of Justice Security Printer Program & SB151 security requirements. Use this style when prescribing multiple drugs (up to three per script). Up to eight prescribers and/or locations may be included in the imprint area at top of form. Second part transfers the information you write (patient name, DOB, medication prescribed, etc.) from the top copy. No other printing on part two. Refer to the price list for current pricing and ordering increments.

Size:

5" x 7"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

PL2

Laser Prescription Forms

1

Click here for more details.

$99.95

Description:

5x7" Prescription Script Area on an 8.5x11" Carrier

Size:

5x7"

Paper:

Rx Security Script

Ink:

Blue & Black

Form ID:

LPF

Non Secure Pads

1

Click here for more details.

$69.00

Description:

Non-secure RX pads

Size:

4.25" x 5.5"

Paper:

RX pads

Ink:

Blue & Black

Form ID:

NS

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