Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Prescriptions-Indiana / Kentucky

Prescriptions-Indiana / Kentucky

Indiana/Kentucky Prescription Blanks:

Indiana/Kentucky State mandated prescription blanks with several security features built into the design.

This design is to be used by all physicians who write prescriptions for controlled narcotic substances in Indiana and Kentucky.

Format:
1 Part,5 1/2" x 4 1/4",padded in 100's
Indiana Scripts have a Blue Void Background.
Kentucky Scripts have a Green Void Background.

Fax heading information to (973) 252-1885 and be sure to reference your order number. A faxed proof will be provided prior to printing.


Indiana / Kentucky Prescription Blanks

Data Business Systems
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