www.PrescriptionPaper.com
www.RxPaper.com
www.ScriptPaper.com
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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.

    High Security TWO PART Prescription Pads


    click to enlarge Rx Paper Base Stock available for printing One and Two Part Scripts


    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"


    TWO PART SCRIPT:
    Part 1 has Distinctive BLUE security background
    Part 2 is a BLANK YELLOW sheet
    50 sets per pad with wrap-a-round cover

    Back Printing on part 1 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
    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"
    50 sets per pad
    with wrap-a-round cover
    Rx610
    TWO PART Pads

    ITEM# Rx610
    Script Size: 5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    Rx610

    Rx610 - 2 part
    for use when prescribing ONE or MORE MEDICATIONS per script.

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

    20 pads
    $10.25 per pad
    plus shipping
    by UPS

    20 Pads WITH
    NUMBERING
    $11.50 per pad
    plus shipping
    by UPS


    40 pads
    $8.00 per pad
    plus shipping
    by UPS

    40 Pads WITH
    NUMBERING
    $10.00/pad
    plus shipping
    by UPS

    80 pads
    $6.00 per pad
    plus shipping
    by UPS

    80 Pads WITH
    NUMBERING
    $7.50/pad
    plus shipping
    by UPS

    160 pads
    $5.50 per pad
    plus shipping
    by UPS

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

    Format Rx620
    includes 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"
    50 sets per pad
    with wrap-a-round cover
    Rx620
    TWO PART Pads
    ITEM# Rx620
    Script Size: 5-1/2" x 4-1/4"
    Imprint up to 4 Names
    (3 Names plus Facility)

    Rx610

    Rx620 - 2 part
    For prescribing
    ONLY ONE
    MEDICATION

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

    20 pads
    $10.25 per pad
    plus shipping
    by UPS

    20 Pads WITH
    NUMBERING
    $11.50 per pad
    plus shipping
    by UPS


    40 pads
    $8.00 per pad
    plus shipping
    by UPS

    40 Pads WITH
    NUMBERING
    $10.00/pad
    plus shipping
    by UPS

    80 pads
    $6.00 per pad
    plus shipping
    by UPS

    80 Pads WITH
    NUMBERING
    $7.50/pad
    plus shipping
    by UPS

    160 pads
    $5.50 per pad
    plus shipping
    by UPS

    160 Pads WITH
    NUMBERING
    $6.75/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
    to your prescriptions
    with Tamper Evident
    Security Hologram Labels

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

    rev 2/15