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Tamper Resistant Secure Laser Prescription Paper
Prescription Pads and Thermal Rx Paper Rolls
for Dentists, Dental Health Care Professionals & Dental Clinics
The move from Schedule III to Schedule II of highly addictive hydrocodone combination painkillers, such as Vicodin, took effect October 6, 2014. |
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 Rx Pads by State |
 Laser/Ink Jet Rx Paper by State |
 Rx Thermal Rolls by State |
All Micro Format Prescription Paper Products
meet and exceed ALL FDA Recommended and Medicaid Requirements.
View Features
See how they relate to Medicaid Requirements.
Print prescriptions with your Laser or Ink Jet Printer.
Laser Rx Paper Directory
Sheet Size: 8.5in. x 11in.
- Rx503 Blue Laser Prescription Paper
Our most popular Laser Rx Paper format for use with Dental Software. - Rx503G Green Laser Prescription Paper
- Rx503-P2 (perforated in half)
- Rx503G-P2 Green Laser Prescription Paper (perforated in half)
- Rx503-P3 (perforated in thirds)
- Rx503-P4 (perforated into quarters)
- Rx503-P5 (Perforated-Landscape Script top left)
- Rx503-P6 (Perforated-Landscape Script bottom left)
- Rx503-C2 (cut in half)
- Rx503-C4 (cut into quarters)
Rx503
Tamper Resistant Dental Laser Prescription Paper
- Sheet size: 8-1/2" x 11"
- 24# Security Paper (90gsm)
- Tamper Resistant SECURITY FEATURES INCLUDE:
- Blue Security Background
The word "VOID" appears when script is photocopied
- Erasure Protection
White Mark appears when erased with ink eraser - Small Production Coded Batch Number in margins on back of sheet
- Acid Free Bond
Prevents paper color deterioration - Security Watermark on back of sheet
Hold on 45 degree angle to light to view
When duplicated - Artificial Watermark is not visible on copy - Coin activated Security on back of script
Rub with coin to validate script
- Security Feature Warning Box on back of sheet
Security Features listed in warning box on reverse side of script
It is important to note that copier technology is ever changing.
Thus messages hidden on Document Security Paper will appear most of the time.
However messages cannot be guaranteed to appear 100% of the time
when used with all copiers or scanners.
FAQ ~ Frequently Asked Questions
- Blue Security Background
- Not approved for use in the States of Alaska , Delaware, Florida, Georgia, Indiana, Kentucky, Maine, New Jersey, New York, Washington
- This format may be used in the State of California ONLY for prescribing Non-Controlled Substance medications
- Meets ALL Medicaid Requirements.
View Security Features and how they relate to the Medicaid Requirements.
Rx503 FULL SHEET Dental Laser Rx paper
Our most popular Laser Rx Paper Format.
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- Item# Blue Background Rx503-P4
8.5in. x 11in.
(perforated to yield 4 scripts when detached)
Click to Enlarge Rx503-P4 imageSecure Tamper Resistant Laser Prescription Paper ~ 4 scripts per sheet
500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton)
$212.50 plus shipping by UPS
2 cartons (2,500 sheets per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per carton)
$175.00 per carton plus shipping by UPS
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Rx503-P5
Laser Rx Paper format for use with Dentrix Dental Software.
Click to Enlarge Rx503-P5 image- Item# Blue Background Rx503-P5
8.5in. x 11in.
Landscape Script in Top Left-Hand Corner of Sheet
Special Perforated FULL SHEET Prescription Paper
to yield script one script 5-1/2" x 4-1/4"
Horizontal perforation 4-1/4" from top edge
Vertical perforation 5-1/2" from left edge
VIEW FEATURESSecure Tamper Resistant Laser Prescription Paper - Script in Top Left-Hand Corner
500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per package)
$212.50 plus shipping by UPS
2 cartons (2,500 sheets per package)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per package)
$175.00 per carton plus shipping by UPS
- Item# Blue Background Rx503-P3
8.5in. x 11in.
(perforated to yield 3 scripts (8-1/2" x 3-2/3") when detached)
Click to Enlarge Rx503-P3 imageSecure Tamper Resistant Laser Prescription Paper ~ 3 scripts per sheet
500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton)
$212.50 plus shipping by UPS
2 cartons (2,500 sheets per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per carton)
$175.00 per carton plus shipping by UPS
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- Item# RX503-P2
8.5in. x 11in.
Blue Background
Tamper Resistant
Laser Rx Paper
500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton)
$212.50 per carton plus shipping by UPS
2 cartons (2,500 sheets per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per carton)
$175.00 per carton plus shipping by UPSItem# RX503G-P2 500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton)
$212.50 per carton plus shipping by UPS
2 cartons (2,500 sheets per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per carton)
$175.00 per carton plus shipping by UPS
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- Item# Blue Background Rx503-C4
8.5in. x 11in.
(cut into quarters - script size 4-1/4" x 5-1/2")
VIEW FEATURESSecure Tamper Resistant Laser Prescription Paper - Each Sheet Cut into 4 Scripts
500 sheets per package (yield 2,000 scripts per package)
$ 70.00 plus shipping by UPS
1000 sheets per package (yield 4,000 scripts per package)
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton - yield 10,000 scripts per carton)
$212.50 plus shipping by UPS
2 cartons (2,500 per carton - yield 10,000 scripts per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 per carton - yield 10,000 scripts per carton)
$175.00 per carton plus shipping by UPS
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- Item# Blue Background Rx503-C2
8.5in. x 11in.
(cut in half - script size 5-1/2" x 8-1/2")
VIEW FEATURESSecure Tamper Resistant Laser Prescription Paper - Each Sheet Cut into 2 Scripts
500 sheets per package (yield 1,000 script per package)
$ 70.00 plus shipping by UPS
1000 sheets per package (yield 2,000 scripts per package)
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per carton - yield 5,000 scripts per carton)
$212.50 plus shipping by UPS
2 cartons (2,500 sheets per carton - yield 5,000 scripts per carton)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per carton - yield 5,000 scripts per carton)
$175.00 per carton plus shipping by UPS
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- Item# Blue Background Rx503-P6
8.5in. x 11in.
Landscape Script in Bottom Left-Hand Corner of Sheet
Special Perforated FULL SHEET Prescription Paper
to yield script one script 5-1/2" x 4-1/4"
Click to Enlarge Rx503-P6 image
Horizontal perforation 4-1/4" from bottom edge
Vertical perforation 5-1/2" from left edge
VIEW FEATURESSecure Tamper Resistant Laser Prescription Paper - Script in Bottom Left-Hand Corner
500 sheets per package
$ 70.00 plus shipping by UPS
1000 sheets per package
$ 90.00 plus shipping by UPS
1 carton (2,500 sheets per package)
$212.50 plus shipping by UPS
2 cartons (2,500 sheets per package)
$200.00 per carton plus shipping by UPS
4 cartons (2,500 sheets per package)
$175.00 per carton plus shipping by UPS
"HIPAA" Compliant
Patient Sign-In Sheets
English/Spanish available
SELF EXPIRING LABELS, VISITOR and NAME BADGES 
Self Expiring Visitor Name Badge
with Record Copy
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For additional information relative to SECURITY PRESCRIPTION FORMS,
contact Micro Format, Inc.
Copyright © 2013- Micro Format, Inc., All Rights Reserved
Micro Format, Inc.
Phone: 920-859-0500
Toll Free: 833-322-1882
Email: CustServ@RxMicroFormat.com
Address: 1434 Progress Lane, Omro, WI 54963 - Item# Blue Background Rx503-P4
