California AB 149 Compliant Security Prescription Order Form
CLICK HERE TO DOWNLOAD THE PDF ORDER FORM OR FILL IT OUT DIGITALLY HERE:
IMPORTANT PLEASE READ:
BY LAW, orders MUST be shipped and delivered VIA CERTIFIED MAIL TO THE ADDRESS ON STATE MEDICAL LICENSE OR DEA REGISTRATION. When your order is shipped A SIGNATURE WILL BE REQUIRED when the package is delivered.
ALL orders MUST be accompanied by a copy of EACH PHYSICIAN’S DEA REGISTRATION AND STATE LICENSE (required by DOJ on all orders) EVEN ON REPEAT ORDERS. We cannot process ANY ORDER for which we do not have a current DEA certificate.
PLEASE EMAIL ALL NECESSARY PAPERWORK TO nesi@printmasterlosal.com
We are a certified printer and our goal is to maintain the security and integrity required by DOJ for Printmasters and its prescribers.Our prescription forms are printed on tamper-resistant paper and contain all required security features, including reverse Rx, California Security Prescription watermark, void pantograph, thermochromatic ink, erasure protection, batch and sequential numbering, and bar codes. Prescription forms will be printed in a secure environment as required by DOJ, and proper documentation will be maintained by Printmasters, per DOJ guidelines. DEA and State License information will be verified from all prescribers prior to each order.
1 and 2 part forms
Single and Multiple Prescriptions
Single and Multiple Prescribers