Standard Duplicate Prescription Pad, 1 doctor, 5.5"x4.25, (2-part NCR Not Security)

Customize this item in 3 simple steps:
1. Enter the appropriate data
2. Check your customized PDF proof
3. Order the item

It's that easy!
click to enlarge
Each 5.5"x4.25" pad has 50 two part sets, original (white) and duplicate (yellow)
Minimum order quantity is 5 pads
Your price will be shown after quantity is entered.
Pricing for sample quantities:
5 qty $90.00   ($18.00 ea.)
10 qty $110.00   ($11.00 ea.)
20 qty $148.00   ($7.40 ea.)
50 qty $264.00   ($5.28 ea.)
Step 1: Enter Your Custom Information
Please enter the information that you would like to appear on your prescription pad.
Please carefully check the accuracy of all the information on your PDF proof.
Doctor Firstname Lastname
License Category (MD,DDS,etc.)
Type of Practice (optional)
CA License number
DEA number
NPI number (optional)
Medical Group Name
Address line 1
Address line 2
Step 2: Check Your PDF Proof
(No PDF Proof available, please complete Step 1)