Prescription Forms and Pads

National Prescription Forms

Vertical National Generic Prescription Forms

Stock 20 lb. White Bond
Imprinted up to 6 lines plus DEA and License Number
Printed 1 color Black Ink, 1 side, Size: 4-1/4" x 5-1/2"
Padded 100 sheets to a pad.

Form No. NGV-1

10 Pads	20 Pads	40 Pads	100 Pads
$ 23.95	$41.95	$72.75	$167.95

Fax us your existing sample or on a separate piece of paper what you want printed on your prescription pads. Include any special wording required by your state not shown on the prescription pad samples.

Horizontal National Generic Prescription Forms

Stock 20 lb. White Bond
Imprinted up to 6 lines plus DEA and License Number
Printed 1 color Black Ink, 1 side, Size: 4-1/4" x 5-1/2"
Padded 100 sheets to a pad.

Form No. NGH-1

10 Pads	20 Pads	40 Pads	100 Pads
$ 23.95	$ 41.95	$72.75	$167,95

Fax us your existing sample or on a separate piece of paper what you want printed on your prescription pads. Include any special wording required by your state not shown on the samples.

New York Prescription Forms

Stock 20 lb. White Bond
Imprinted up to 6 lines plus DEA and License Number
Printed 1 color Black Ink, 1 side, Size: 4-1/4" x 5-1/2"
Padded 100 sheets to a pad.

Form No. NYPRES-1

10 Pads	20 Pads	40 Pads	100 Pads
$ 24.95	$ 43.95	$75.95	$169.95

Fax us your existing sample prescription form or on a separate piece of paper what you want printed on your prescription pads.

New Jersey Prescription Forms

1 Part - Stock 20 lb. New Jersey Bond
Imprinted up to 5 lines
Plus DEA and License Number
Printed 1 color Black Ink, 2 sides.
Size: 4" x 5-1/2"

The Lowest Price Anywhere For Style A - N.J Pads
Medical-Dental-Veterinary

Form No. NJP-1

10 Pads	20 Pads	40 Pads	100 Pads
$ 29.95	$ 48.95	$84.95	$182.95

DRS is an authorized Supplier of
New Jersey Prescription Pads

Fax us your existing sample or on a separate piece of paper what you want printed on your prescription pads.

New Jersey requirements: All new and repeat orders must be signed by the physician. Multiple names require multiple signatures. Shipment is to the licensed address only. Only one imprinted address allowed on the face of the prescription pad. DEA numbers do not have to be printed but can be replaced by a rule line for the physician to write in the number. License number must be printed.

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