Need a larger size? Our Jumbo Alter-Resistant Prescription Blanks feature a tamper-resistant green background on white safety paper, which has invisible ultra-violet fibers and provides anti-forgery protection against bleach or solvent washing. Our green background pattern appears on both sides of the prescription blank and makes any erasures immediately apparent. These alter-resistant blanks can be faxed or copied for your files. Meets Medicaid Security Requirements.

Size: 8" x 4-5/8". Choose from one or two-part Rx's. Submit your personalized information using our attached Alter-Resistant Rx/Prescription Blanks Jumbo Size order layout*.

Simply click on our attached, easy to use order form above. Our order layout also includes all ordering specifications & pricing. Simply print the order layout, complete the form, and fax or mail.

Click here to view the requirements that apply to Rx Forms used in your state.

An alter-resistant blank sheet (8-1/2" x 11") is also available, without personalization, for laser printers.

Don't see what you are looking for or need additional assistance? Call us at (800) 242-2376.

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