Up to 15 Names / Addresses (may require 3 RX Format)
--see other products for single name / address.
California approved for controlled substance prescriptions.
Customizable to meet your needs--
- CA DOJ approved security features
- Bar code and sequential numbering
- Larger than our standard pads (3.67" x 8.5")
- Choice of 3 line or 5 line formats.
- Choice of 1-part or 2-part (with carbonless copy).
- Available with optional wraparound cover.
- Custom Designs Available--Call for Details
- Institutional Discount Pricing Available--Call for Details
At Checkout, please upload an Excel or Word file with the following information.
Please be sure all information is as you want it to appear on the pad:
--Provider Names
--DEA and License Numbers
--NPI Numbers (if desired)
--Addresses
--Phone / Fax Numbers
A proof copy with be added into your account for approval.
We MUST receive proof approval before we can proceed with your order.
California law requires all secure Rx orders to be shipped ONLY to the
address of record with the DEA or board license on record for the provider.
Price displayed below includes $5 signature-required delivery charge, as required by CA law.