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

Prescriptions -New Jersey

Prescriptions -New Jersey

New Jersey Prescription Blanks
DBS is an authorized vendor for New Jersey Prescriptions. They are available in both Laser/Deskjet or traditional padded format.

Format:
Laser / Deskjet:
8.5" x 11", 1 Part with Script located top center or top left position.
Padded:
5.5" x 4, 1 part padded in 100's.

Please fax a copy of your existing script or required heading information to (973) 252-1885.

State law requires that all scripts be printed with practice information, National Provider Identification Numbers and to be consecutively numbered.


View Sample
JPEG
Laser Format-

View Sample
JPEG
Padded Format

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