New Jersey

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Micro Format, Inc. is a distributor for Wilmer. Wilmer is a New Jersey Approved manufacturer for prescription pads and laser prescription paper.

  • Printed prescriptions take 7 to 10 business days for production.
  • New Jersey requires all prescriptions be shipped signature required to your address of record.
  • Before we can process any orders for prescriptions, we must receive a copy of your state medical license, this is the address we are required to ship to. We also need a completed Signature Form, which can be obtained by downloading the PDF. These forms can be returned to us at custserv@rxmicroformat.com
 

New Jersey Medical Doctor Pad

NJMD_1120X880

  • This prescription pad is 4 x 5-1/2 inches.
    • The format will fit five (5) lines of text, including the Practice Name, up to Three Providers and One Address, or Four Providers and no Practice Name.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • Each Providers License and NPI must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey Physician Assistant Pad

NJ_PA_1120X880

  • This prescription pad is 4 x 5-1/2 inches.
  • New Jersey law requires only ONE Physician Assistant's name per script with ONE Supervising Physician's name. Both the Physician Assistant's name and information plus the Supervising Physician's name and information must be pre-printed on script.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey APN Pad

NJ_APN_1120x880

  • This prescription pad is 4 x 5-1/2 inches.
  • New Jersey law requires only ONE Advance Practice Nurse's name per script with ONE Collaborative Physician's name. Both the Advance Practice Nurse's name and information plus the Collaborative Physician's name and information must be pre-printed on script.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey OD Pad

NJ_OPTOMITRIST_1120X880

  • This prescription pad is 4 x 5-1/2 inches.
  • The format will fit five (5) lines of text, including the Practice Name, up to Three Providers and One Address, or Four Providers and no Practice Name.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • Each Providers License and NPI must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey Midwife Pad

NJ_MIDWIFE_1120X880

  • This prescription pad is 4 x 5-1/2 inches.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • Each Providers License and NPI must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey Eyeware Pad

NJ_EYEWARE1120X880

  • This prescription pad is 4 x 5-1/2 inches.
  • The format will fit five (5) lines of text, including the Practice Name, up to Three Providers and One Address, or Four Providers and no Practice Name.
  • 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.
  • Back Printing available for an additional charge if additional addresses are desired.
  • Each Providers License and NPI must be pre-printed on the prescription. Please include this information in the imprint section, when placing order.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS

New Jersey Facility Pad

NJ_Facility_1120x880

  • This prescription pad is 4 x 5-1/2 inches.
  • 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.
  • To use this format your facility must provide your state Healthcare Facility Number to be printed on the pad.
  • All prescriptions in New Jersey must be consecutively number, please select YES in the CONSECUTIVE NUMBERING box when asked.
  • 8 Pads per Pack
  • PLEASE NOTE: Two-part pad orders start at 16 pads!

    • VIEW DETAILS
 

Security Notes

New Jersey regulations relative to medical prescription paper took effect on November 4, 2014. Per regulation, all prescription paper must be manufactured by a New Jersey approved Rx paper printer. Micro Format Inc., is a distributor of Wilmer, a New Jersey approved Rx Paper Printer. Approved manufacturers may only sell prescription paper products to those authorized by the state of New Jersey to purchase prescription products. New Jersey State Law requires that all Rx Paper Orders are shipped to the address on file with the State of New Jersey. After submitting your order the Micro Format Compliance Department on behalf of Wilmer, requires that you send a copy of your State License and completed signature form to our customer service department by FAX (847-520-0197). Orders will be processed ONLY after we have received your forms, failure to submit them will delay the production of your order. This site is designed for use by doctors, healthcare professionals and medical clinics. Proper documentation is required to purchase from this site and all orders are reviewed for compliance. Any attempt to purchase prescription papers 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. .