Click on the link below to download the Order Form for ALL OTHER STATES. 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:
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
| SINGLE SHEET SCRIPTS |
| Quantity |
1000 |
2000 |
3000 |
4000 |
5000 |
10,000 |
| Price |
$34.95 |
$39.95 |
$59.95 |
$69.95 |
$86.95 |
$159.95 |
| S/H** |
$7.95 |
$9.95 |
$10.95 |
$11.95 |
$11.95 |
$15.95 |
| Total |
$42.90 |
$49.90 |
$70.90 |
$81.90 |
$98.90 |
$175.90 |
|
| 2-PART SCRIPTS* |
| Quantity |
1000 |
2000 |
3000 |
4000 |
5000 |
10,000 |
| Price |
$79.95 |
$135.95 |
$161.95 |
$189.95 |
$235.95 |
$411.95 |
| S/H** |
$8.95 |
$10.95 |
$11.95 |
$12.95 |
$12.95 |
$16.95 |
| Total |
$88.90 |
$146.90 |
$173.90 |
$202.90 |
$248.90 |
$428.90 |
|
* 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
|
