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  • TAMPER RESISTANT
    Secure Laser Prescription ( Rx ) Paper
    for Doctors, Healthcare Professionals & Medical Clinics

    Micro Format Tamper Resistant Laser Prescription Paper
    meet and exceed ALL Medicaid Requirements

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

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

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

    State of North Dakota

    Acceptable Secure Laser Rx Papers for use in the State of North Dakota
    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