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Maximum Security Rx Pad
Highest security with 11 advanced tamper-resistant features. Ideal for prescribers who need maximum fraud protection and peace of mind.
Minimum Security Rx Pad
Meets compliance requirements while keeping costs low. A smart choice for backup scripts when electronic prescriptions are the primary method.
Standard (Non-Secure) Rx Pad
Affordable and versatile, perfect for general prescriptions. Save your high-security pads for controlled substances.
Secure EMR Laser Prescription Paper
Tamper-resistant paper that meets state and federal standards—ideal for medical offices and pharmacies needing secure printing.
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Pennsylvania Max Security Rx Pad
Quantity of Pads
Choose an option
8 Pads - $135
16 Pads - $210
24 Pads - $295
40 Pads - $450
80 Pads - $775
Type of Paper
Choose an option
Single Ply (100 scripts per pad)
Two-Ply Carbonless (50 scripts per pad)
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Pennsylvania Max Security Rx Pad
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WooCommerce Order
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State
Product Name
Production Time
Standard - 5 Business Days
Expedited - Next Business Day (+95)
Add your logo to the pad?
No
Yes
Total Price:
Practice Details
Add Your Locations
You may add up to three locations;
at least one is required.
Practice Name
Address
Phone
Actions
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Locations.
Add Location
Maximum number of locations reached.
Upload Your Practice Logo
(Required)
Drop files here or
Select files
Max. file size: 2 GB, Max. files: 1.
Prescriber Information
Print Prescriber Information on Pad?
(Required)
Yes, pre-print my prescriber's information
No, only include blank spaces for manual entry*
You can include up to 6 prescribers pre-printed on your pad, or you can choose to omit all prescriber information and require every script to be manually filled. You can also choose to add a secondary space for manual prescriber entry alongside pre-printed prescribers. * We still require a primary prescriber's credentials to complete your order, for verification purposes; enter it in the section below, even if you do not want it printed on the pad.
Add Prescriber Details
You must add 1-6 prescribers.
Prescriber Name
Designation
State License Number
DEA Number
NPI Number
Actions
Edit
Delete
There are no
Prescribers.
Add Prescriber
Maximum number of prescribers reached.
Delaware DELPROS Number
(Required)
A DELPROS number is required for Delaware orders and is used to ensure that only licensed healthcare providers and authorized institutions are allowed to purchase prescription forms.
Add Blank Prescriber Line?
If you would like to add a blank prescriber line that you can manually fill out, indicate that here.
Yes
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Other Details
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Delaware?
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Pennsylvania Max Security Rx Pad quantity
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