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Custom Imprinted
Tamper Resistant

Pennsylvania PRESCRIPTION PADS

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

Rx670

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Standard Format Rx Pads are approved for issuing "fraud proof" Medicaid Scripts.

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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.

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Note for Nurse Practitioners and Physician's Assistants:
The State of Pennsylvania requires that the name of a supervising physician appear on scripts.

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Pennsylvania SECURE PRESCRIPTION PAD PRICE LIST Rx670 To ORDER - CLICK ON "Add to your Shopping Cart" ONE PART (single script) Pads 100 scripts per pad TWO PART Pads 50 sets per pad with wrap-around cover 20 pads ONE PART SCRIPTS $7.75 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 20 Pads ONE PART WITH NUMBERING $10.25 per pad plus shipping Rx670 Click to PURCHASE this item 20 pads TWO PART SCRIPTS $10.25 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 20 Pads TWO PART WITH NUMBERING $11.50 per pad plus shipping Rx670 Click to PURCHASE this item 40 pads ONE PART SCRIPTS $6.00 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 40 Pads ONE PART WITH NUMBERING $8.25/pad Rx670 Click to PURCHASE this item 40 pads TWO PART SCRIPTS $8.00 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 40 Pads TWO PART WITH NUMBERING $10.00/pad Rx670 Click to PURCHASE this item 80 pads ONE PART SCRIPTS $5.00 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 80 Pads ONE PART WITH NUMBERING $6.75/pad Rx670 Click to PURCHASE this item 80 pads TWO PART SCRIPTS $6.00 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 80 Pads TWO PART WITH NUMBERING $7.50/pad Rx670 Click to PURCHASE this item 160 pads ONE PART SCRIPTS $4.75 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 160 Pads ONE PART WITH NUMBERING $6.25/pad Rx670 Click to PURCHASE this item 160 pads TWO PART SCRIPTS $5.50 per pad plus shipping by UPS Rx670 Click to PURCHASE this item 160 Pads TWO PART WITH NUMBERING $6.75/pad Rx670 Click to PURCHASE this item

Micro Format Tamper Resistant Rx Pads meet and exceed ALL Medicaid Requirements. 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 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.

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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 Meets Federal and State Regulations.

SELF EXPIRING LABELS, VISITOR and NAME BADGES Self Expiring Visitor Name Badge with Record Copy

Add an Additional Level of Security with Tamper Evident Security Hologram Labels

PATIENT SIGN-IN LOGS SecureGuard™Patient Sign-In Form Each "Sign-In Log" includes 20 sign-in label strips

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

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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

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rev 2/15