Rx Duplicate Pad Sets 33309 | Prescription | Broward

Duplicate Prescription Pads

Duplicate Pad Sets - 2 part pads (25 sets per pad) 4.25" x 5.5"

Multiple part, carbon-less sets. Tamper resistant prescription pads

printed on secure prescription paper. Meets state regulations -

Tamper and copy proof technology

Security Features

Void Pantograph • Microprint Line • Watermark on Back • Preprinted prescriber information • Blue background

Fill information below to place your order

Prescriber's Name (Required)

Clinic or Business Name (Required)

Address (Line 1) (Required)

Address (Line 2)

City (Required)

State (Required)

ZIP Code (Required)

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Fax (Required)

E-mail Address (Required)

DEA Number (Required)

License Number (Required)

NPI Number (Required)

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Orientation (Required)

Prescriber (Required)

Additional Prescriber's (as it will appear on form)

Preferred Response

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