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  • State of Massachusetts

    EFFECTIVE JULY 1, 2013
    All Prescriptions used in the State of Massachusetts
    MUST meet Medicaid Requirements.

    All Micro Format SecureGuard Prescription Paper Products
    MEET and EXCEED Medicaid Requirements

    SecureGuard™ Rx Prescription Paper Products meets and exceed the NEW FDA Recommendations

    VERY IMPORTANT

    "A prescription issued by a nurse practitioner, psychiatric nurse, physician assistant, nurse anesthetist or pharmacist shall also contain the name of the supervising physician."

    Acceptable Secure Laser Rx Papers for use in the State of Massachusetts

    Rx503 Tamper Resistant Laser Script Paper
    Rx503
    8-1/2" x 11" full sheet
    Tamper Resistant script

    Laser Script Rx503 front
    Front

    Laser Script Rx503 back
    Back

    Item# RX503G
    8.5in. x 11in.
    Green Background Tamper Resistant
    Laser Rx Paper

    Rx503-P2
    to yield 2 scripts (8-1/2" x 5-1/2") when detached)

    Blue Background
    Rx503-P2 (perforated in half)

    Rx503-P2small

    Item# RX503G-P2
    8.5in. x 11in.
    Green Background
    Tamper Resistant
    Laser Rx Paper

    Item# Rx503-P3
    8.5in. x 11in.
    Blue Background
    (perforated to yield 3 scripts (8-1/2" x 3-2/3") when detached)

    Click to Enlarge Rx503-P3
    Click to Enlarge Rx503-P3 image

    Item# Rx503-P4
    8.5in. x 11in.
    Blue Background
    (perforated to yield 4 scripts when detached)

    Click to Enlarge Rx503-P4
    Click to Enlarge Rx503-P4 image


    Item# Rx503-C4
    8.5in. x 11in.
    Blue Background
    (cut into quarters - script size 4-1/4" x 5-1/2")


    Item# Rx503-C2
    8.5in. x 11in.
    Blue Background
    (cut in half - script size 5-1/2" x 8-1/2")


    Item# Rx503-P5
    8.5in. x 11in.
    Blue Background
    Landscape Script in Top Left-Hand Corner of Sheet
    Special Perforated FULL SHEET Prescription Paper
    to yield script one script 5-1/2" x 4-1/4"

    Rx503-P5

    Horizontal perforation 4-1/4" from top edge
    Vertical perforation 5-1/2" from left edge

    Item# Rx503-P6
    Blue Background
    8.5in. x 11in.
    Landscape Script in Bottom Left-Hand Corner of Sheet
    Special Perforated FULL SHEET Prescription Paper
    to yield script one script 5-1/2" x 4-1/4"

    Click to Enlarge Rx503-P6
    Horizontal perforation 4-1/4" from bottom edge
    Vertical perforation 5-1/2" from left edge

    Additional Approved Laser Rx Paper Formats
    Rx510 Laser Script

    8-1/2" x 11"
    with script in top left-hand corner


    Rx510
    SHEET SIZE 8-1/2" x 11"
    Laser Rx Paper

    Detached script size
    4-1/4" x 5-1/2"

    Rx505 Laser Script

    8-1/2" x 11"
    with script in top half of sheet


    Rx505
    SHEET SIZE 8-1/2" x 11"
    Laser Rx Paper

    Detached script size
    5-1/2" x 8-1/2"

    RxEC503 Laser Script

    5-1/2" x 8-1/2" sheet
    2 scripts per sheet over/under

    Tamper Resistant Laser Rx Paper Laser Script Paper
    RxEC503
    NOTE --- This sheet size is 5-1/2" x 8-1/2"
    NOT 8-1/2" x 11"


    For additional information relative to SECURE PRESCRIPTION FORMS,
    contact Micro Format at Support@prescriptionpaper.com


    USA flag - Micro Format, Inc. Micro Format, Inc. is a veteran owned company.
    Micro Format SecureGuard Paper Products are manufactured in the USA from American Made materials.


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

    Micro Format, Inc. 
    830-3 Seton Court ~ Wheeling, IL 60090 
    847/520-4699 FAX 847/520-0197
    800-333-0549