| Security Feature CategorIes (as defined by CMS) |
#04541
Blue
Security |
#04542
Green
Security |
#04543
Blue
Prescription |
#04544
2-part
Carbonless |
#04548
17'' X 11''
Prescription |
| Category 1: Features designed to prevent unauthorized copying of completed or blank prescription forms. |
| “VOID”pantograph |
|
 |
 |
 |
 |
| “UNAUTHORIZED COPY”pantograph |
 |
|
|
|
|
| Printed watermarks |
|
 |
 |
 |
 |
| Coin-reactive ink on watermark |
|
 |
 |
 |
 |
| Microprinting (part of Security Listing Box border) |
 |
 |
 |
 |
 |
| Category 2: Features designed to prevent erasure ormodification of information written by a prescriber. |
| Colored background with erasure protection |
 |
 |
 |
 |
 |
| Chemical-reactive paper |
|
|
 |
|
 |
| Paper-Toner Grip on both sides of paper |
|
|
 |
|
 |
| Category 3: Features designed to prevent the use of counterfeit prescription forms. |
| Security Listing Box with formnumber* |
 |
 |
 |
 |
 |
| Invisible fibers embedded in paper |
|
|
 |
|
 |
| Heat-sensitive thermochromatic ink |
|
|
 |
|
 |
| Second sheet with“COPY” and“Rx” (carbonless) |
|
|
|
 |
|