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CA Approved Pads
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Select:
1-part 100 rx/pad
2-part 50 sets/pad
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Quantity:
5
10
20
40
60
80
100
120
* Style:
Please Select
Standard Format (1 RX / Sheet)
Plus Format (3 RX / Sheet)
Add logo:
Please Select
No Logo
Repeat logo
New logo. (one-time $35 setup charge, upload new file at checkout)
Order Options:
2 part RX Wraparound Cover OPTION (add $1 per pad)
RX Numbering:
Please Select
1 part Rx/1st sheet: Included
2 part Rx OPTION: Number both sheets (adds $1 per pad)
Production Time:
Please Select
Standard Delivery Available
RUSH - Not available at this time
Project Name:
4.25 x 5.5 CA RX Pads (1 Name / 1 Address)
One Provider Name With One Location Address
California approved for controlled substances.
Form size is 4.25" x 5.5"
OPTIONS AVAILABLE:
Dulpicate (2 part) Rx carbonless form
One prescription or three prescription format
(choose format option in design template)
2 part Rx form available with wrap around covers
REQUIRED BY LAW:
Contains all CA DOJ approved security features.
Includes bar coding and sequential numbering
.
CA secure Rx pads can ONLY ship to the address of recorded on file with the DEA or appropriate regulatory board. No exceptions can be made.
CA secure Rx base template, wording and set up cannot be changed. Formatting is preset and approved by CA DOJ