Click on the link below to download the Order Form for NEW JERSEY MD/DO/DDS/DMD/DPM/DVM/VMD/BVSc. 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 |
800 |
1600 |
2400 |
3200 |
4000 |
4800 |
9600 |
| Price |
$53.95 |
$74.95 |
$99.95 |
$124.95 |
$154.95 |
$174.95 |
$314.95 |
| S/H** |
$10.95 |
$12.95 |
$13.95 |
$14.95 |
$15.95 |
$16.95 |
$18.95 |
| Total |
$64.90 |
$87.90 |
$113.90 |
$139.90 |
$170.90 |
$191.90 |
$333.90 |
|
| 2-PART SCRIPTS* |
| Quantity |
800 |
1600 |
2400 |
3200 |
4000 |
4800 |
9600 |
| Price |
$94.95 |
$109.95 |
$154.95 |
$220.95 |
$284.95 |
$334.95 |
$614.95 |
| S/H** |
$11.95 |
$13.95 |
$14.95 |
$15.95 |
$16.95 |
$17.95 |
$19.95 |
| Total |
$106.90 |
$123.90 |
$169.90 |
$236.90 |
$301.90 |
$352.90 |
$634.90 |
|
* 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
|
