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Custom Imprinted
Tamper Resistant
PRESCRIPTION PADS

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

Protect your medical prescriptions from unauthorized duplication with
High Security ONE PART Prescription Pads

Choose Your Format.
Format Rx610
for prescribing ONE or MORE MEDICATIONS per script.
Format Rx620 (shown above) 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.

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

Distinctive BLUE Colored Background

Blue background Erasure Protection

Security watermark on reverse side of prescription

Warning Band on face specifying security features

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 for use when prescribing ONE or MORE MEDICATIONS per script. To Order ... click on the "Add to Your SHOPPING CART" button.	20 pads $6.70 per pad plus shipping by UPS 20 Pads WITH NUMBERING $9.05 per pad plus shipping by UPS 40 pads $4.85 per pad plus shipping by UPS 40 Pads WITH NUMBERING $7.10/pad plus shipping by UPS 80 pads $3.50 per pad plus shipping by UPS 80 Pads WITH NUMBERING $5.25/pad plus shipping by UPS 160 pads $3.05 per pad plus shipping by UPS 160 Pads WITH NUMBERING $4.50/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.

Ultrasound Thermal Printer Paper

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

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

Custom Imprinted Tamper Resistant PRESCRIPTION PADS

Custom Imprinted
Tamper Resistant
PRESCRIPTION PADS