California Laser EMR Prescription Paper


www.CaliforniaRxPaper.com
www.CaliforniaPrescriptionPaper.com

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  • TAMPER RESISTANT
    LASER
    California Rx Prescription Paper

    California laser Rx Paper

    Custom Imprinted
    Laser Medical Prescription Script Paper for use in the State of California


    Micro Format is a California State Approved manufacturer
    for Tamper Resistant Prescription Pads

    Micro Format Secure Prescription Paper contains all of the features
    required by the California State Legislation.



    Notice to ALL in Medical Community
    If you prescribe painkillers such as Vicodin, you MUST write or computer print your prescription on SECURE Rx Paper.

    The move from Schedule III to Schedule II of highly addictive hydrocodone combination painkillers, such as Vicodin, took effect October 6, 2014.
    Doctors, who under schedule III could prescribe a six-month supply as a 30-day prescription with up to five refills, are now limited to prescribing a three-month supply under schedule II. The rule also mandates that doctors must write the prescriptions in 30-day increments that can only be filled sequentially.
    Pain patients using these drugs will have to visit their doctors every three months for a new prescription.

    SecureGuard™ Rx Prescription Paper Products meets and exceeds the FDA Recommendations for prescribing controlled substance prescriptions.

    FEDERAL REGISTER
    The Daily Journal of the United States Government


    After you complete your order ...
    California Law requires that a copy of your DEA Registration be sent to us by FAX.
    This is a State requirement.

    We cannot process any order for which we do not have a current DEA Registration form on file.
    Please FAX a copy of your DEA Registration form to
    MICRO FORMAT Customer Service
    Fax Number: (847)520-0197

    Thank you.

    Once we receive your DEA Registration Certificate, it will be reviewed along with your order form. After it has been determined that everything is in order, your order will be processed.


    PA prescription Authority Documentation

    A PA must have their DEA registration AND supervising physician's information on their prescriptions.

    California Law requires that a physician assistant authorized to write controlled substance drug orders pursuant to authority granted to them by their supervising physician and DEA registration, must have their supervising physician's name, DEA registration number, address, and telephone number preprinted on the physician assistant's preprinted controlled substance prescription form.


    All Prescription Pad Orders MUST BE ENTERED ON LINE
    We cannot accept orders for prescription pads by Fax.
    =

    California Prescription Paper Imprinting Information
    and your Credit Card Payment Information will be requested
    AFTER you have clicked on the "Add to Your SHOPPING CART" button

    Due to State of California Regulations, un-imprinted laser scripts are not available.

    When Requested,
    Please accurately fill-in the information that needs to be imprinted on the top of each sheet.

    • California law requires scripts must contain both the DEA# and License# for each doctor listed.
    • A copy of the DEA Registration for each doctor listed must be sent to us by FAX.

    • Under California Law ... ALL California Laser Prescription Paper
      MUST BE SHIPPED to the address on file with the DEA

    Printing on the BACK of each script is available at an additional charge of $50.00 per 1000 sheets.
    This charge will not show on your order at the time you enter your order.
    This charge will be added to the invoice total when it is charged to your credit card.

    This charge will be added to the total price of your order.

    Included in this charge is printing THREE LINES of text copy
    Information must fit into THREE LINES of TEXT copy.

      Three lines of text copy may be:

    • THREE NAMES plus license numbers
    • TWO NAMES plus ONE LOCATION
    • THREE LOCATIONS
    • Other combination of names and locations

    If additional information needs to be printed on the back of each script,
    an additional COMPOSITION charge of $100.00 will be added to the total price for this order.
    You will be required to sign a composition approval before your order will be printed.

    For additional information please CALL Customer Service at (800)333-0549.
    For a FACILITY to qualify as a
    LICENSED HEALTH CARE FACILITY so you can order INSTITUTION style controlled substance prescription forms -- it must be a licensed facility pursuant to Article 1 (commencing with section 1250) of Chapter 2 of Division 2 of the California Health and Safety Code.

    Article 1 Section 1250

    Micro Format, Inc. is obligated by law to insure only those qualified can purchase medical prescription paper for use in the State of California. For Micro Format to manufacture INSTITUTION STYLE controlled substance prescriptions forms, we require an affidavit be signed attesting to the fact you have read
    Article 1 Section 1250 of Chapter 2 of Division 2 of the California Health and Safety Code
    and that your health care facility meets the necessary requirements.

    Please click here for the required affidavit.
    Licensed Health Care Facility AFFIDAVIT



    California Approved Laser Prescription Paper
    Five Formats Available
    Item #RxL775
    Sheet Size: 8-1/2" x 11"


    Click to Enlarge - RxL775
    Item #RxL812
    Sheet Size: 8-1/2" x 11"


    Click to Enlarge - RxL812
    Item #RxL785
    Sheet Size: 5-1/2" x 8-1/2"

    Click to Enlarge RxL785

    Item #RxL720
    Sheet Size: 5" x 7"

    Click to Enlarge RxL720

    Item #RxL810
    Sheet Size: 8-1/2" x 11"

    click to enlarge RxL810
    This format is printed with one set of the state required
    QUANTITY CHECK BOXES
    This format DOES NOT contain the
    state required Quantity Check Boxes

    If you use this format, your computer MUST print the required Check Boxes.
    This format is printed with one set of the state required
    QUANTITY CHECK BOXES
    This format is printed with one set of the state required
    QUANTITY CHECK BOXES
    This format is printed with one set of the state required
    QUANTITY CHECK BOXES
  • Item# RxL775
    Script Size:
    5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    To order ........
    Click On
    "Add to Shopping Cart"


    1,000 sheets ~ $199.00
    plus shipping
    by UPS


    2,000 sheets ~ $312.00
    plus shipping
    by UPS


    4,000 sheets ~ $539.00
    plus shipping
    by UPS


    8,000 sheets ~ $988.00
    plus shipping
    by UPS


  • Item# RxL812
    Script Size:
    5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    To order ........
    Click On
    "Add to Shopping Cart"


    1,000 sheets ~ $199.00
    plus shipping
    by UPS


    2,000 sheets ~ $312.00
    plus shipping
    by UPS


    4,000 sheets ~ $539.00
    plus shipping
    by UPS


    8,000 sheets ~ $988.00
    plus shipping
    by UPS


  • Item# RxL785
    Script Size:
    5-1/2" x 4-1/4"
    Imprint up to 4 names
    (3 Names plus Facility)

    To order ........
    Click On
    "Add to Shopping Cart"


    2,000 sheets ~ $320.00
    plus shipping
    by UPS


    4,000 sheets ~ $475.00
    plus shipping
    by UPS


    6,000 sheets ~ $659.00
    plus shipping
    by UPS


    8,000 sheets ~ $839.00
    plus shipping
    by UPS


  • Item# RxL720
    Script Size:
    5" x 7"
    Imprint up to 8 names
    (7 Names plus Facility)

    To order ........
    Click On

    "Add to Shopping Cart"


    2,000 sheets ~ $320.00
    plus shipping
    by UPS


    4,000 sheets ~ $475.00
    plus shipping
    by UPS


    6,000 sheets ~ $659.00
    plus shipping
    by UPS


    8,000 sheets ~ $839.00
    plus shipping
    by UPS


  • Item# RxL810
    Script Size:
    5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    To order ........
    Click On
    "Add to Shopping Cart"


    1,000 sheets ~ $199.00
    plus shipping
    by UPS


    2,000 sheets ~ $312.00
    plus shipping
    by UPS


    4,000 sheets ~ $539.00
    plus shipping
    by UPS


    8,000 sheets ~ $988.00
    plus shipping
    by UPS


  • FullSheet
    Thank You for your order for Secure California Prescription Forms.
    We appreciate your business.
    Your order will ship in approximately 10 to 12 business days.
    Please allow up to 4 days for shipping by UPS.

    QUESTIONS: Please send us an e-mail support@rxpaper.com
    Copyright © 1995- Micro Format, Inc., All Rights Reserved
    Micro Format, Inc.
    830-3 Seton Court ~ Wheeling, IL 60090
    Phone: 847/520-4699 ~ 800-333-0549
    Fax 847/520-0197


    rev 1/2016