Order Tamper Resistant Prescription Pads Online

WE SHIP YOUR PRESCRIPTION PAD ORDER WITHIN 24-48 HOURS (2 business days)

Our scripts meet and exceed all Federal and all individual State requirements, for Medicaid* (*except KY, IN, NY)

Links

SSL Certificate Authority

•  California

•  Florida

•  New Jersey

•  Washington

•  Wyoming

•  All Other States

New Jersey Scripts by Fax/Mail/E-Mail

Click on the link below to download the Order Form for NEW JERSEY MD/DO/DDS/DMD/DPM/DVM/VMD/BVSc. Print the Order Form, fill it out and fax it with a copy of your current VOIDED script along with payment information to our toll free fax number:

1-800-500-3060

Alternatively, you can print the order form, fill it out and mail it in with a VOIDED script and payment to:

National Rx Security
535 2nd Street, S.W.
Vero Beach, FL 32962

Prices for New Jersey Scripts

SINGLE SHEET SCRIPTS
Quantity	800	1600	2400	3200	4000	4800	9600
Price	$59.95	$84.95	$114.95	$144.95	$179.95	$199.95	$359.95
S/H**	$12.95	$13.95	$14.95	$15.95	$16.95	$17.95	$19.95
Total	$72.90	$98.90	$129.90	$160.90	$196.90	$217.90	$379.90

2-PART SCRIPTS*
Quantity	800	1600	2400	3200	4000	4800	9600
Price	$94.95	$109.95	$154.95	$220.95	$284.95	$334.95	$614.95
S/H**	$13.95	$15.95	$16.95	$17.95	$18.95	$19.95	$21.95
Total	$108.90	$125.90	$171.90	$238.90	$303.90	$354.90	$636.90

* 2-PART = 50 Original scripts and 50 blank copy sheets
** For AK, HI, and PR, there will be an extra $10 added to cover the additional Priority Mail shipping charges

		New Jersey MD/DO Order Form Adobe Acrobat Document 15 KB

		New Jersey Eyewear Order Form Adobe Acrobat Document 14 KB

		New Jersey Eyewear & Rx Order Form Adobe Acrobat Document 14 KB

		New Jersey Nurse Order Form Adobe Acrobat Document 14 KB

		New Jersey Optom TPA Cert Order Form Adobe Acrobat Document 14 KB

		New Jersey PA Order Form Adobe Acrobat Document 14 KB