• Compliant with October, 2008 Medicaid requirements and section 7002(b) of the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007.
• Horizontal layout
• One-part form
• Includes text required in Texas regarding generic equivalents: "A generically equivalent drug product may be dispensed unless the practitioner hand writes the words "Brand Necessary" or "Brand Medically Necessary" on the face of the prescription."
• Security features include a red spot with heat-sensitive ink, microprinting, invisible fibers, and a true watermark visible when held to light.
• Designed to prevent unauthorized copying of a completed or blank prescription form
• Designed to prevent the erasure or modification of information written on the prescription by the prescriber
• Designed to prevent the use of counterfeit prescription forms
• Also acceptable for use in Mississippi
• 100 forms per pad, sold in bundles of 10 pads (1000 forms).

This item is for sale to healthcare practitioners only. ALL ORDERS FOR RX BLANKS will be verified by phone prior to shipment.

QUANTITY DISCOUNTS are available - Call 800-878-2822 for an instant quote!