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.
FL Custom Tamper Resistant Prescription Pads
Custom Florida Tamper Resistant Prescription pad, 2-part, 100 per pad, Choice of Sizes. 4 1/4 x 5 1/2 or 5 1/2 x 4 1/4, must be blue or green ink, 2nd part printed same. Includes all security features required by Florida for non-electronically transmitted Medicaid prescriptions, including security batch number. License Number Verification Required. PRICE IS PER PAD, MINIMUM ORDER IS 10 PADS.
Imprinted with blue or green ink (specify below). Second Part printed the same as first. We may be able to use your logo if art files are in PDF format, Adobe® Photoshop®, Illustrator®, EPS or TIF. Art charges may apply to rearrange or resize your design, or if one of these formats is not available. Please type imprint information. Be sure to include: all Doctor's names, Specialties, License #s and DEA #s as well as each office address and phone number. Email logo to: firstname.lastname@example.org.
Ancom Business Products an InHealth Company