•  California

•  Florida

•  New Jersey

•  Wyoming

•  All Other States


***For CALIFORNIA CONTROLLED substance scripts with an exclusive
hologram, please visit our sister company at www.scriptshield.com
to view prices and download an Order Form.***

For CALIFORNIA NON-CONTROLLED substance scripts, click on the link below to download the Order Form. 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:

1-800-500-3060

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

California Non-Controlled Substance Order Form
Adobe Acrobat Document
14 KB
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