Pacific Printing | Prescription Pads

Single-Part Pads

1

Single-Part Standard-Size Pads - Only 1 Medication(1PS1)

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$64.95

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

Single-Part Standard-Size Pads - Up to 3 Medications(3PT1)

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$69.95

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

Single-Part Large Size Pads - Up to 3 Medications(PL1)

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$89.95

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

Two-Part Standard-Size Pads - Only 1 Medication(2PS2)

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$79.95

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

Two-Part Standard-Size Pads - Up to 3 Medications(4PT2)

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$87.95

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

Two-Part Large-Size Pads - Up to 3 Medications(PL2)

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$99.95

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

Laser Prescription Forms(LPF)

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$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

Non Secure(NS)

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$69.00

Description:

Non-secure RX pads

Size:

4.25" x 5.5"

Paper:

RX pads

Ink:

Blue & Black

Form ID:

NS

Single-Part Standard Size (4 x 5)
100-Scripts Per Pad
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	100	64.95	64.95
4	400	25.40	101.60
8	800	17.10	136.80
10	1000	14.50	145.00
20	2000	14.20	284.00
40	4000	10.80	432.00
50	5000	10.75	537.50
60	6000	10.65	639.00
80	8000	10.35	828.00

Single-Part Standard Size (4 x 5)
100-Scripts Per Pad
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	100	69.95	69.95
4	400	27.70	110.80
8	800	18.70	149.60
10	1000	15.80	158.00
20	2000	15.45	309.00
40	4000	11.80	472.00
50	5000	11.70	585.00
60	6000	11.60	696.00
80	8000	11.30	904.00

Single-Part Large Size (5 x 7)
100-Scripts Per Pad
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	100	89.95	89.95
4	400	47.15	188.60
10	1000	32.45	324.50
20	2000	26.70	534.00
40	4000	21.70	868.00
50	5000	20.45	1,022.50

Two-Part Standard Size (4 x 5)
50-Scripts Per Pad - Part Two Blank
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	50	79.95	79.95
4	200	36.45	145.80
8	400	22.15	177.20
10	500	19.60	196.00
20	1000	17.05	341.00
40	2000	14.95	598.00
50	2500	14.85	742.50
60	3000	14.65	879.00
80	4000	14.30	1,144.00

Two-Part Standard Size (4 x 5)
50-Scripts Per Pad - Part Two Blank
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	50	87.95	87.95
4	200	39.75	159.00
8	400	24.20	193.60
10	500	21.30	213.00
20	1000	18.05	361.00
40	2000	15.85	634.00
50	2500	15.75	787.00
60	3000	15.50	930.00
80	4000	14.95	1,196.00

Two-Part Large Size (5 x 7)
50-Scripts Per Pad - Part Two Blank
No. of Pads	No. of Scripts	Price Per Pad	Total Price
1	50	99.95	99.95
4	200	60.50	242.00
10	500	37.55	375.50
20	1000	31.70	634.00
40	2000	26.40	1,056.00
50	2500	24.75	1,237.50

Laser Prescription Forms
No. of Forms	Total Price
100	$99.95
500	$248.00
1000	$350.00
2500	$700.00
5000	$1,075.00
10000	$1,495.00

Non Secure
No. of Pads	No. of Scripts	Price Per Pad	Total Price
4	100	17.25	69.00
8	100	12.38	99.00

Prescription Pads

Prescription Pads

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

Single-Part Pads

Single-Part Standard-Size Pads - Only 1 Medication(1PS1)

Pricing Matrix

Single-Part Standard-Size Pads - Up to 3 Medications(3PT1)

Pricing Matrix

Single-Part Large Size Pads - Up to 3 Medications(PL1)

Pricing Matrix

Two-Part Pads

Two-Part Standard-Size Pads - Only 1 Medication(2PS2)

Pricing Matrix

Two-Part Standard-Size Pads - Up to 3 Medications(4PT2)

Pricing Matrix

Two-Part Large-Size Pads - Up to 3 Medications(PL2)

Pricing Matrix

Laser Prescription Forms

Laser Prescription Forms(LPF)

Pricing Matrix

Non Secure Pads

Non Secure(NS)

Pricing Matrix

PLEASE CHOOSE YOUR LOCATION

california

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