Products

Security Features:

• Front & Back Padlock Icon
• Warning Band
• Microprint Border
• Microprint Signature Line
• Microprint Endorsement Line
• Warning Box
• Original Document Security Background
• Heat Sensitive Icon
• Void Pantograph

Description:

• Check prints on top of page
• Check size 8.5" x 3.5"
• 500 sheets per pack

Security Features:

• Front & Back Padlock Icon
• Warning Band
• Microprint Border
• Microprint Signature Line
• Microprint Endorsement Line
• Warning Box
• Original Document Security Background
• Heat Sensitive Icon
• Void Pantograph

Description:

• Check prints on top of page
• Check size 8.5" x 3.5"
• 500 sheets per pack

Security Features:

• Front & Back Padlock Icon
• Warning Band
• Microprint Border
• Microprint Signature Line
• Microprint Endorsement Line
• Warning Box
• Original Document Security Background
• Heat Sensitive Icon
• Void Pantograph

Description:

• Check prints on top of page
• Check size 8.5" x 3.5"
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Back of form is blank
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Includes Mastercard, Visa Discover, and American Express accepted on front
• Heading information is computer generated
• Remittance Portion included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change and credit card payment information is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change Format is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Includes Mastercard and Visa accepted on front
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforations 3-9/16" from top edge
• Information Change and credit card payment information is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Heading information is computer generated
• Front of form is completely blank
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change Format is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Includes Mastercard, Visa and Discover accepted on front
• Heading information is computer generated
• Remittance portion included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change and credit card payment information is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Includes Mastercard, Visa and Discover accepted on front
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change and credit card payment information is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Includes Mastercard and Visa accepted on front
• Heading information is computer generated
• "Remittance Portion" included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change and credit card payment information is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• #20 white laser bond paper with distinctive shaded colored background
• Heading information is computer generated
• Remittance Portion included at the top of the form
• This paper includes horizon perforation 3-9/16" from top edge
• Information Change Format is provided on the back of the Remittance Portion
• Folds easily into our self-seal double window statement envelope
• 500 sheets per pack

• This prescription paper is 8-1/2 x 11 inches and provides space for up to THREE medications to be prescribed .
• The format will fit five lines of text, including the Practice Name, two providers and two addresses, or any combination of the three.
• Back Printing is available for an additional charge if more space is needed for additional providers or addresses.
• Each Provider's License and DEA must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
• All prescriptions in California must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
• 1,000 sheets per pack

• This prescription paper is 8-1/2 x 11 with the 5-1/2 x 4-1/4 inch script in the upper left corner.
• The format will fit five (5) lines of text, including the Practice Name, Two (2) Providers and Two (2) Address, Or any combination of the three.
• Back Printing available for an additional charge if more space is needed for additional providers or addresses.
• Each Providers License and DEA must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
• All prescriptions in California must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
• 1,000 sheets per pack

• This prescription is approved for use in Delaware and meets all state and federal regulations.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• All prescriptions come with Consecutive Numbering as required by the state (PLEASE SELECT YES IN THE CONSECUTIVE NUMBER BOX WHEN ASKED) .
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• Self-seal double window envelopes are easy to use
• No moisture needed
• Includes fold up adhesive flap and a fold down envelope flat that seal when pressed together
• Window size 4-1/8" x 1"
• Bottom window position is 5/8" from bottom edge and 3/8" from left edge
• 1,000 per carton

• Micro Format, Inc. is an approved Florida State prescription printer.
• This prescription is approved for use in Florida and meets all state and federal regulations.
• All prescriptions are printed with the required Acute & NonAcute Pain Exception boxes, and required Florida State Batch Number.
• This prescription pad is designed for use when prescribing only one medication and includes the following text at the bottom of the prescription: “PRESCRIPTION IS VOID IF MORE THAN ONE (1) PRESCRIPTION IS WRITTEN PER BLANK”.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• Consecutive Numbering: Select YES if you would like your prescriptions numbered. There is an additional charge for numbering.
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• This prescription is approved for use in Georgia and meets all state and federal regulations.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• These pads come consecutive numbered
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• This prescription is approved for use in Indiana and meets all state and federal regulations.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank white carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• Consecutive Numbering: Select YES if you would like your prescriptions numbered. There is an additional charge for numbering.
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• This prescription is approved for use in Kentucky and meets all state and federal regulations.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
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• Consecutive Numbering: Select YES if you would like your prescriptions numbered. There is an additional charge for numbering.
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• This prescription meets all state and federal regulations for use in Louisiana.
• This prescription pad is designed for use when prescribing one or more medications.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• Consecutive Numbering: Select YES if you would like your prescriptions numbered. There is an additional charge for numbering.
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack

• This prescription is approved for use in Maine and meets all state and federal regulations.
• This format is available as either a One-Part Script or a Two-Part Script: One-Part Pads have the secure prescription and contain 100 sheets per pad. Two-Part Pads have the secure prescription and a blank yellow carbonless copy. They contain 50 sets per pad and include a protective wrap-around cover.
• Consecutive Numbering: Select YES if you would like your prescriptions numbered. There is an additional charge for numbering.
• Back Print: Select YES if you need additional providers or addresses printed on the backside of the prescription. There is an additional charge for back printing.
• 20 Pads Per Pack