Laser Rx Paper Forms w/ Horizontal Perforation & Black Imprint

Item # ROJXG-OTUXE

These prescription sheets exceed federal requirements and are 100% Medicaid compliant. These prescription sheets are 2-part, and there are 500 sheets per package. The sheets are tamper-resistant with numerous security features. Security features include: Invisible fluorescent fibers, Microprinting, Colored background on white paper, Preprinted prescriber information, Thermochromic ink, Security feature listing, Artificial watermark, Watermark in coin reactive ink, Scallop VOID pantograph, Reverse Rx (when required by state), Laser prescription sheet, 8-1/2" x 5-1/2", 2-part, 500 sheets per package, Tamper-resistant with numerous security features, Medicaid compliant, and Black imprint with choice of a blue or green background. Complies with Prop 65. 8 ½" W x 11" H

Qty Options


Quantity: 500 1,000 2,500 5,000 7,500
Your Price (each): $0.1873 $0.1143 $0.1035 $0.094 $0.0671
Additional charges may apply.


Blue, Green

Office, Banking

1 color, 1 location

Production Time: Approximately 15 working days

Packaging: Bulk

Shipping Point: 56003 (Minnesota, United States)