site search
Home
About Us
Login
Order Status
Contact Us
>> Laser Checks
>> Payroll Checks
>> Promotional Products
>> Self Inking Stamps
All Checks
Binders
Document Jackets / Folders
>> Continuous & Dot Matrix Checks
>> Blank Laser Checks
>> Deposit Tickets
>> Envelopes
>> Manual/Paper Checks
>> Holiday Cards
>> Tax Forms
Select ...
Broker
DFS
Ennis
Independent
Pyramid
Ennis Northstar
Home
PP-2601 / 2603
Product Options
Quantity and One or Two Part:
Select Quantity and One or Two Part
4 Pads (400 Forms) 1 Part
8 Pads (800 Forms) 1 Part
12 Pads (1200 Forms) 1 Part
16 Pads (1600 Forms) 1 Part
20 Pads (2000 Forms) 1 Part
40 Pads (4000 Forms) 1 Part
80 Pads (8000 Forms) 1 Part
120 Pads (12000 Forms) 1 Part
160 Pads (16000 Forms) 1 Part
200 Pads (20000 Forms) 1 Part
8 Pads (400 Forms) 2 Part
16 Pads (800 Forms) 2 Part
24 Pads (1200 Forms) 2 Part
32 Pads (1600 Forms) 2 Part
40 Pads (2000 Forms) 2 Part
80 Pads (4000 Forms) 2 Part
120 Pads (6000 Forms) 2 Part
180 Pads (9000 Forms) 2 Part
240 Pads (12000 Forms) 2 Part
300 Pads (15000 Forms) 2 Part
Personalization
Practice Name
Answer
Prescribers Name, Degree
Answer
Alternate Line
Answer
Address
Answer
City, State, Zip Code
Answer
Phone
Answer
FAX
Answer
DEA #
Answer
License Number
Answer
Quantity:
Email this page to a friend
These Prescription Pads exceed Center for Medicare and Medicaid Services (CMS) guidelines". Security Features Include These pads are compliant with the latest new requirements for use of tamper-resistant precription pads uner the Medicaid program, Section 1903b(i) of the Social Security Act (42USC193b(i), paragraph (23)). Compliant in all states except California, Connecticut, Kentucky, New Jersey, New York and Wyoming. SIZE 4 1/4 X 5 1/2" VERTICAL
1 Part - 100 per pad
2 part - 50 per pad
True watermark paper with visible and invisible fibers, chemically reactive ink and bleach reactivity. script
Colored background with Anti-Copy "VOID" protection
Heat sensitive Thermochronic image
Micro Printing
Raster Relief Image
Warning banks
Lot control number
Sequentially numbered for internal record keeping
Product Reviews
Login to rate or review this product
(0 Ratings, 0 Reviews)
Email Address:
Password:
Remember Me
Create an account
Forgot Password?
Your cart is empty.