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Custom Imprinted
Tamper Resistant

PRESCRIPTION PADS for use in U.S. Territories
Very Important:
After placing your order ..... a copy of the doctor's DEA certificate MUST be sent to customer service by FAX.
Fax a copy of the DEA certificate to (847)520-0197. Orders for Rx Paper from U.S. Territories will only be processed once a copy of the DEA Certificate has been received by our customer service department.
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
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Protect your medical prescriptions from unauthorized duplication with High Security Prescription Pads
(Available 1 part and 2 part)


All Prescription Pad Orders MUST BE ENTERED ON LINE
We cannot accept orders for prescription pads by Fax. =
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TWO FORMATS AVAILABLE.
- Format Rx610
is designed for use when prescribing MORE THAN ONE MEDICATION.
- Format Rx620 (shown above)
includes the following text at the bottom of the script.
"PRESCRIPTION IS VOID IF MORE THAN ONE (1) PRESCRIPTION IS WRITTEN PER PAGE"
Prescriptions can be consecutively numbered for an additional charge
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. However it will be added to the total cost of your order.
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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