CLINICAL FORMS LASER PRESCRIPTION FORMS A B LASER PRESCRIPTION FORMS * Conveniently print prescriptions from your practice software or computer programs * All papers meet " tamper-resistant " Medicaid requirements effective October 2008 * Configurations available in full sheets (A), half-perforated sheets (C), and quarter-perforated sheets (D) * Dentrix-compatible blanks (B) feature a 51 ⁄2 " W x 11 " H ⁄2 " W x 41 ⁄4 " H script that detaches from the top left * " Color Change Ink " security feature paper (E) available for added security (not required by Medicaid) * Paper size: 81 A. Full Sheet (367-9217) 500 per Pkg 2 Pkg@ B. Full Sheet with Detachable Top Left Script (367-5299) 500 per Pkg 2 Pkg@ C. 1 ⁄2 Perforated Sheet (367-5297) 500 per Pkg 2 Pkg@ * All products featured above are NOT for use in states that require state-approved prescription blanks E D. 1 ⁄4 Perforated Sheet (367-5298) 500 per Pkg 2 Pkg@ E. Full Sheet with Color-Changing Ink (367-6658) 500 per Pkg 2 Pkg@ C D For our complete offering of Dental Procedure Coding Books California CALIFORNIA STATE-APPROVED LASER PRESCRIPTION PERSONALIZED FORM Full Sheet with Detachable Top-Left Script * Form complies with state-mandated personalization requirements * Paper size: 81 ⁄2 " W x 11 " H California (368-1734)1000 per Box 2 Boxes @ 154 For pricing information and/or to place an order, visit: www.henryscheindental.com See page 141 For Imprinted Materials, contact: professional.promotions@henryschein.com Compatible with Compatible with Compatible with Compatible withhttp://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3679217%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3679217 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3675298%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3675298 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3675299%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3675299 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3676658%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3676658 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3675297%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3675297 http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3681734%26CatalogName%3DDENTAL%26utm_source%3DDental%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing20222023%26utm_term%3D3681734 http://www.henryscheindental.com