NJ Prescription Blanks - PC41 - MD, DDS, DMD, DPM, DVM
The mandated changes gives four option for Prescriptions Blanks; 1-Part Prescription Pads, 2-Part Prescription Pads, 1-Up Laser Prescription Forms, 4-Up Laser Prescription Forms.
Requirements include; printing on each form with name, street, city, state, zip code, telephone number, and the prescriber’s New Jersey professional license/registration number, DEA #, Repetitive Hollow Void Pattern, Thermochromic “Rx” Ink, NJ State Seal Background, Security Back Print and Unique ID & Barcode, Microprinting. Below are the details of each option. After you have decided which option fits you best, please click on the option for ordering details.
1 Part Prescription Pad
Imprint Ink: Black
Size: 4”w x 5-1/2”h
Paper: 20# Laser Bond
Padding: 100 Sheets per Pad
Options: Back Print
50 Sheets per Pad
Rush Service
PC41-NJ14
2 Part Prescription Pad
Imprint Ink: Black, ply 1 and 2
Ply 2 is not printed
Size: 4”w x 5-1/2”h
Paper: Part 1 - 20# Laser Bond
Part 2 - 20# Canary Bond
Padding: 100 Forms per Pad
Options: Back Print Part 1 of 2
Part 2 Face Print
Drill Part 2
50 Sheets per Pad
Rush Service
PC41-NJ214
1 Up Prescription Laser Form
Size: 8-1/2”w x 11”h
Paper: 20# Laser Bond
Trimmed and Perfed for Digital Printer
1 Prescription Form per Sheet
PC41Z-NJ14
4 Up Prescription Laser Form
Size: 8-1/2”w x 11”h
Paper: 20# Laser Bond
Trimmed and Perfed for Digital Printer
4 Prescription Form per Sheet
PC41Z-NJ4UP14