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NJ Prescription Blanks - PC44 - Nurse Practioner/Clinical

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

PC44-NJ14

PC44-NJ214

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

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

 

PC44Z-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

 

PC44Z-NJ4UP14