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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

    If you dispense Sample Medications ...
    You need the SecureGuard™
    Sample Medication Label Recording System
    SAMPLE MEDICATION Recording System
    Meets Federal and State Regulations.
    State of Louisiana

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

    Rx503
    SHEET SIZE 8-1/2" x 11"
    Tamper Resistant Laser Rx Paper
    is available in many different formats
    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

    RxEC503
    SHEET SIZE 5-1/2" x 8-1/2"
    Laser Rx Paper

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

    If you would rather print a Fax Order Form
    to send in your order by fax
    Click HERE for
    Laser Prescription FAX ORDER FORM
    Our Fax Number is (847)520-0197
    For additional information relative to SECURE PRESCRIPTION FORMS,
    contact Micro Format at Support@4securitypaper.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. 
    Phone: 920-859-0500
    Toll Free: 833-322-1882
    Email: CustServ@RxMicroFormat.com
    Address: 1434 Progress Lane, Omro, WI 54963