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    Custom Imprinted
    Tamper Resistant


    MISSOURI 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.

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

    Missouri High Security Prescription Pads
    (Available 1 part and 2 part)


    Rx611

    All Prescription Pad Orders MUST BE ENTERED ON LINE
    We cannot accept orders for prescription pads by Fax.
    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.
    SECURE Rx PAD PRICE LIST
    Rx611
    To ORDER - CLICK ON
    "Add to your Shopping Cart"

    Order 1 part Pads Below
    100 scripts per pad    		 Order 2 part Pads Below
    50 sets per pad
    with wrap-around cover
    20 pads
    ONE
    PART
    SCRIPTS
    $7.75
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    20 Pads
    ONE PART
    WITH
    NUMBERING
    $10.25 per pad
    plus shipping
    RX611
    Click to PURCHASE this item
    		20 pads
    TWO
    PART
    SCRIPTS
    $10.25
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    20 Pads
    TWO PART
    WITH
    NUMBERING
    $11.50 per pad
    plus shipping
    RX611
    Click to PURCHASE this item
    40 pads
    ONE
    PART
    SCRIPTS
    $6.00
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    40 Pads
    ONE PART
    WITH
    NUMBERING
    $8.25/pad

    RX611
    Click to PURCHASE this item

    		40 pads
    TWO
    PART
    SCRIPTS
    $8.00
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    40 Pads
    TWO PART
    WITH
    NUMBERING
    $10.00/pad

    RX611
    Click to PURCHASE this item

    80 pads
    ONE
    PART
    SCRIPTS
    $5.00
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    80 Pads
    ONE PART
    WITH
    NUMBERING
    $6.75/pad

    RX611
    Click to PURCHASE this item

    		80 pads
    TWO
    PART
    SCRIPTS
    $6.00
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    80 Pads
    TWO PART
    WITH
    NUMBERING
    $7.50/pad

    RX611
    Click to PURCHASE this item

    160 pads
    ONE
    PART
    SCRIPTS
    $4.75
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    160 Pads
    ONE PART
    WITH
    NUMBERING
    $6.25/pad

    RX611
    Click to PURCHASE this item

    		160 pads
    TWO
    PART
    SCRIPTS
    $5.50
    per pad
    plus shipping
    by UPS

    RX611
    Click to PURCHASE this item

    160 Pads
    TWO PART
    WITH
    NUMBERING
    $6.75/pad

    RX611
    Click to PURCHASE this item

    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.

    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. 
    Phone: 920-859-0500
    Toll Free: 833-322-1882
    Email: CustServ@RxMicroFormat.com
    Address: 1434 Progress Lane, Omro, WI 54963
    rev 02/2015