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Prescription Pads

Prescription Pads

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

Two-Part Standard-Size Pads - Only 1 Medication

You may order pads in any quantity, for pricing refer to pricing matrix

To begin your order, complete this form.

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