Dental Health 2017 Catalog

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Order by 800-626-2163 Fax: 888-681-5088
FORMS
599
FORM #3373
Excuse Slips and Prescription Pads
Concerned over the problems associated with counterfeiting and forgery of prescription forms?
Several state health agencies outline specific guidelines for issuance of prescription forms for
Schedule II controlled substances. 4-1/4" x 5-1/2", 50# blue offset copy proof paper.
Excuse Pads
Contains: 3 pads of 50 sheets per pad.
Prescription Pads
Contains: 5 pads of 50 sheets per pad.
* Call for pricing.
Front Front
We can customize your prescription pads. Ask your DHPI Account Manager for details.
Family Dental Center
444 South Monroe
Fremont, Wisconsin 54222
555-222-0000
Printed on security
watermark paper to
prevent fraud
EXCUSE AND PRESCRIPTION PADS