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www.RxPaper.com
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    Custom Imprinted
    Tamper Resistant
    PRESCRIPTION PADS with Numbering


    Tamper Resistant Rx PADS for DOCTORS and MEDICAL CLINICS
    Micro Format Tamper Resistant Rx Pads meet ALL Medicaid Requirements.

    High Security ONE PART Prescription Pads with Numbering

    Click to Enlarge

    Choose Your Format.

    Format Rx610
    for prescribing ONE or MORE MEDICATIONS per script.

    Format Rx620 for prescribing only ONE MEDICATION per script. Script includes the following text at the bottom of the script.
    "PRESCRIPTION IS VOID IF MORE THAN ONE (1) PRESCRIPTION IS WRITTEN PER PAGE"


    Back Printing is available at an additional $5.00 per pad
    This amount will be added when your order is processed.
    This additional charge for back printing will not be shown
    at the time you place your order. However it will be added
    to the total cost of your order.
    All Pads are CONSECUTIVELY NUMBERED as required


    Micro Format Tamper Resistant Rx Pads meet and exceed ALL Medicaid Requirements.

    This link will provide additional information on the
    Requirement for Use of Tamper Resistant Prescription Pads Under the Medicaid Program, under Section 1903b(i) of the Social Security Act (42 USC193b(i), paragraph (23)


    Micro Format Secure Rx Pads contain the following security features:

  • Hidden Message Technology ~
    "VOID" pantograph
    VOID

  • Distinctive BLUE Colored Background

  • Blue background Erasure Protection

  • Security watermark on reverse side of prescription

  • Rub coin on back to validate script

  • Security Warning Band on face and Security Features listed on back

  • Thermochromatic ink (color changing) Rx symbols on back

  • Unique Production Batch Number

    Thanks to multiple security features, it is virtually IMPOSSIBLE TO ACCURATELY DUPLICATE a script written on Micro Format Security Script paper.


  • Format Rx610

    For prescribing ONE or MORE MEDICATIONS
    per script.

    Rx610 ~ SECURE Rx PAD PRICE LIST
    To ORDER - CLICK ON
    "Add to your Shopping Cart"
    100 scripts per pad
    Rx610
    ONE PART
    (single script) Pads
    100 scripts/pad
    ITEM# Rx610
    Script Size: 5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    Rx610

    Rx610
    for use when prescribing ONE or MORE MEDICATIONS per script.

    To Order ...
    click on the
    "Add to Your SHOPPING CART" button.

    20 Pads WITH
    NUMBERING
    $10.25 per pad
    plus shipping
    by UPS


    40 Pads WITH
    NUMBERING
    $8.25/pad
    plus shipping
    by UPS

    80 Pads WITH
    NUMBERING
    $6.75/pad
    plus shipping
    by UPS

    160 Pads WITH
    NUMBERING
    $6.25/pad
    plus shipping
    by UPS

    Format Rx620
    ONLY ONE MEDICATION per script

    The following text at the bottom of the script.
    "PRESCRIPTION IS VOID IF MORE THAN ONE (1) PRESCRIPTION IS WRITTEN PER PAGE"
    Rx620 ~ SECURE Rx PAD PRICE LIST
    To ORDER - CLICK ON
    "Add to your Shopping Cart"
    100 scripts per pad
    Rx620
    ONE PART
    (single script) Pads
    100 scripts/pad
    ITEM# Rx620
    Script Size: 5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    Rx610

    Rx620
    For prescribing
    ONLY ONE
    MEDICATION

    To Order ...
    click on the
    "Add to Your SHOPPING CART" button.

    20 Pads WITH
    NUMBERING
    $10.25 per pad
    plus shipping
    by UPS


    40 Pads WITH
    NUMBERING
    $8.25/pad
    plus shipping
    by UPS

    80 Pads WITH
    NUMBERING
    $6.75/pad
    plus shipping
    by UPS

    160 Pads WITH
    NUMBERING
    $6.25/pad
    plus shipping
    by UPS


    Under our licensing agreement, all orders for Document Security Paper are reviewed and the information provided is confirmed by our Document Security Compliance Team.
    The use of Script Paper is controlled by Federal and State Agencies. Any attempt to purchase script documents by unauthorized persons or by persons providing falsified information
    will be reported to the proper authorities for prosecution to the full extent of the law.

    Acceptance of any and all orders for Document Security Paper is at the discretion of the Micro Format Document Security Compliance Team.


    Add an Additional Level of Security
    with Tamper Evident
    Security Hologram Labels

    Security Hologram Labels

    Ultrasound Thermal Printer Paper

    SecureGuardtm Maxwell Ultrasound Paper
    for use in hospitals, clinics, OB offices and others.
    Compatible ultrasound paper for use in Sony and Mitsubishi Ultrasound equipment

    If you dispense Sample Medications ...
    You need the SecureGuard™

    Sample Medication Label Recording System
    SAMPLE MEDICATION Recording System

    Meets Federal and State Regulations.
    SELF EXPIRING LABELS, VISITOR and NAME BADGES

    To activate Secure Name Badge

    Visitor Badge with journal

    Self Expiring Visitor Name Badge
    with Record Copy

    PATIENT SIGN-IN LOGS

    Spanish Patient Sign-In Form
    SecureGuard™Patient
    Sign-In Form

    Each "Sign-In Log" includes 20 sign-in label strips


    For additional information relative to SECURITY PRESCRIPTION FORMS,
    contact
    Micro Format, Inc. support@RxPaper.com



    Copyright © 2000- Micro Format, Inc., All Rights Reserved

    Micro Format, Inc. 
    Phone: 920-859-0500
    Toll Free: 833-322-1882
    Email: CustServ@RxMicroFormat.com
    Address: 1434 Progress Lane, Omro, WI 54963

    rev 2/15