Ancom has designed and printed over 1,000 custom professional forms for our customers, including the Healthcare industry, whose offices have relied on our stock professional forms for years. At Ancom, you’ll find the ready-made forms that you need: HIPAA forms, HCFA forms, ADA forms, and Rx pads, along with X-Ray mailers, recall postcards, laser statements and mailing envelopes. To get started on designing your own custom professional form, see our Custom Forms section.
IN Tamper Resistant Prescription Pads
Standard Indiana Tamper Resistant Prescription pad, 2-part, 50 per pad, Size: 5 1/2" x 4 1/4". Imprinted reflex blue ink, duplicate copy printed on part 2. Includes all security features required by Indiana for non-electronically transmitted Medicaid prescriptions as well as narcotic prescriptions. PRICE IS PER PAD, MINIMUM ORDER IS 10 PADS.
Imprinted with reflex blue ink. Second part printed face with "Duplicate Copy." Imprinted title after signature line . List up to 4 doctors, 6 line maximum. Please type imprint information. Be sure to include; physician name, practice name, address and Licence number.
Ancom Business Products an InHealth Company