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State of Georgia
Custom Imprinted
Tamper Resistant
GEORGIA PRESCRIPTION PADS
This site is designed for use by
DOCTORS, HEALTHCARE PROFESSIONALS and MEDICAL CLINICS
Proper documentation is required to order documents from this site.
Tamper Resistant Rx PADS for DOCTORS
and MEDICAL CLINICS
Micro Format Tamper Resistant Rx Pads meet and exceed all State of Georgia and Medicaid Requirements.
Micro Format Georgia Rx Paper Products meet and exceed ALL Medicaid Requirements.
Full details ....
State of GEORGIA
O.C.G.A. 26-4-80.1
December 2011 UPDATE
July 2013 UPDATE (House Bill 209)
While the only Georgia State Requirement is that Rx Scripts used in the State of Georgia must meet Medicaid requirements,
using Georgia Scripts that meet previous regulations will insure the prescriptions you issue are unique, meet all security and Medicaid requirements, and are issued on paper that is ONLY AVAILABLE for purchase by those in the State of Georgia medical community.
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Georgia State Approved Format medical prescriptions pads
(Available 1 part and 2 part)
Rx645
NOTE: Part 2 is BLANK on two part scripts.
For security .... Part 2 must never be mistaken as an original.
 Tamper Resistant Rx Pads
If you prefer not to use Georgia specific Rx Pads
Micro Format Tamper Resistant Rx Pads meet and exceed all Medicaid Requirements.
Georgia Rx Pads are approved for issuing Controlled Substance Prescriptions and "fraud proof" Medicaid Scripts.
Micro Format Secure Rx Pads contain the following security features:
Georgia State Approved Seal
Product Lot Identification Number
Consecutive Number
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
All Prescription Pad Orders MUST BE ENTERED ON LINE
We cannot accept orders for prescription pads by Fax.
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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 below.
ALL Prescriptions for Georgia are consecutively numbered
SECURE Rx PAD PRICE LIST
Rx645
To ORDER - CLICK ON
"Add to your Shopping Cart"
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Order 1 part Pads Below
100 scripts per pad |
Order 2 part Pads Below
50 sets per pad
with wrap-around cover
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20 Pads
one part
WITH
NUMBERING
$9.05 per pad
plus shipping
Rx645
Click to PURCHASE this item
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20 Pads
two part
WITH
NUMBERING
$11.34 per pad
plus shipping
Rx645
Click to PURCHASE this item
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40 Pads
one part
WITH
NUMBERING
$7.10/pad
Rx645
Click to PURCHASE this item
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40 Pads
two part
WITH
NUMBERING
$9.79/pad
Rx645
Click to PURCHASE this item
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80 Pads
one part
WITH
NUMBERING
$5.25/pad
Rx645
Click to PURCHASE this item
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80 Pads
two part
WITH
NUMBERING
$7.23/pad
Rx645
Click to PURCHASE this item
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160 Pads
one part
WITH
NUMBERING
$4.50/pad
Rx645
Click to PURCHASE this item
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160 Pads
two part
WITH
NUMBERING
$5.94/pad
Rx645
Click to PURCHASE this item
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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.
It is important to note that copier technology is ever changing.
Thus messages hidden on all Document Security Paper, including Secure Prescription Paper,
will appear most of the time.
However "hidden VOID messages" cannot be guaranteed to appear 100% of the time
when used with all copiers or scanners.
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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.
Phone: 920-859-0500
Toll Free: 833-322-1882
Email: CustServ@RxMicroFormat.com
Address: 1434 Progress Lane, Omro, WI 54963
rev 2/15
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