We have the Rx pads you need!

Tamper-Resistant Rx Blanks

To be considered tamper-resistant for Medicaid, a prescription form must contain all 3 characteristics.

One or more industry recognized features designed to prevent:

1. Copying – unauthorized copying of a completed or blank prescription form
2. Erasure – the erasure or modification of information written
3. Counterfeit – the use of counterfeit
   prescription forms

Tamper-Resistant Rx Blanks exceed the minimum Medicaid requirements.

Secure Rx with 8 security features: heat sensitive verification box, coin reactant ink, the word "security" in microprint, visible fibers in paper, invisible fluorescent fibers in paper, watermark, chemical sensitivity and void pantograph

Copy-proof Rx with 6 security features: blue pattern background, microprint signature line, void pantograph, security border lists features, reverse Rx and quantity range check boxes

Alter-proof Rx with 5 security features: thermochromic ink strip, blue pattern background, microprint signature line, void pantograph and security border

State Regulated Rx Blanks

• Complies with CMS guidelines and state
  regulated requirements
• Qualifies for controlled substance prescriptions

DOWNLOAD order form template for your state!

• California
• New Jersey
• Medical
• Optometry
• Florida
• Maine
• Wyoming
• Kentucky
• Washington

Fill out the order form and mail or fax it:

• Mail To:
  Medical Arts Press
  P.O. Box 43200
  Minneapolis, MN 55443-0200
• Fax To:
  800-328-0023

Order online:

• Indiana