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  • Custom Printed 2-Part Carbonless Prescription Pads printed on CMS-approved security paper
  • Landscape and portrait dimension comparison

2-Part Carbonless Prescription Pads

Product Description

Custom Printed 2-Part Carbonless Prescription Pads - Priced as Low as $5.00/pad

Order your prescription pads from Lucas Distribution, custom-printed on CMS-approved security paper.  Front page is blue and contains security features.  Back page is yellow and does not contain any security features - only for use as backup record for prescriber.

We offer personalized Rx Pads - normally with 2-3 day turnaround after proof approval.  Expedited delivery available.

The order process is simple - attach a pdf or jpg file of your current pad to your order.  We will prepare a proof copy and email to you for approval before printing. 

If you do not have a sample copy to upload, simply download the encrypted form, enter your practice information, and we will create and email a proof copy for your review and approval.  

After you submit the form with your practice information, please complete your order by selecting the quantity of pads you wish to order and add to your shopping cart.  

Pads are custom-printed with your practice information and come in 50-script pads (50 scripts + 50 carbonless copies).  Minimum order quantity 4 pads (200 scripts).

Pad pricing:

4 pads - $38.00
8 pads - $52.00
12 pads - $72.60
16 pads - $92.80
20 pads - $112.00
24 pads - $134.40
28 pads - $151.20
32 pads - $168.00
36 pads - $183.60
40 pads - $200.00

Pads must be ordered in increments of 4 pads as shown in price list.

Pads are default printed in landscape mode unless portrait mode is selected.  


$2 Flat Rate UPS Ground shipping in the continental United States.  For Hawaii and Alaska orders please contact us for a shipping quote.


We do not offer pads for the following states:

California, Delaware, Florida, Indiana, Kentucky, Maine, New Jersey, New York, Washington State


Important Note: Because these pads are printed on CMS-approved security paper, you must have a copy of your DEA certificate available upon request to order these pads. 

We ship to medical practices.  If shipping to a residential address, we must have a copy of your DEA certificate on file. 

Anyone fraudulently ordering these pads will be reported to local authorities!

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Free Shipping
Minimum Purchase:
4 unit(s)
Maximum Purchase:
40 unit(s)
Only supports a few types. Maximum file size: 2 MB

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