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California compliant (multiple drug format) 5 1/2" x 4 1/4" Horizontal 1-part Rx Pads (4 Pads @ 100 sheets/pad) - Blue
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1

$85.32 ea.

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2 - 2

$60.52 ea.

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3 - 3

$46.56 ea.

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4 - 4

$38.23 ea.

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5 - 9

$31.18 ea.

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10 - 14

$24.18 ea.

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15 - 19

$21.64 ea.

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20 +

$20.00 ea.

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California compliant (multiple drug format) 5 1/2" x 4 1/4" Horizontal 1-part Rx Pads (4 Pads @ 100 sheets/pad) - Blue

Order quantity is by the Pack: 4 pads = 1 Pack

Security Features: Chemical Protection Paper, Scallop Void Pantograph, Blue Background, California Security Prescription Watermark on Back, Preprinted Prescriber Information, Batch & Consecutive Numbering, Rx Thermochromic Ink, License and DEA Numbers, Reverse Rx, Microprinting in Signature Line, Format and Size Requirements, Watermark in Coin Reactive Ink, Printed Security Feature listing.

$85.32
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Item #PRES-CA1BLM-1

California compliant (multiple drug format) 5 1/2" x 4 1/4" Horizontal 1-part Rx Pads (4 Pads @ 100 sheets/pad) - Blue

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Clinic or Business Name
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Zip Code
Phone #
Fax #
1 - Prescriber Name
1 - License #
1 - DEA #
2 - Prescriber Name
2 - License #
2 - DEA #
3 - Prescriber Name
3 - License #
3 - DEA #
4 - Prescriber Name
4 - License #
4 - DEA #


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