Get National Rx Security

Filling out the National Rx Security form is a straightforward process designed to streamline prescription pad ordering. This guide provides a step-by-step approach to ensure you complete the form accurately and efficiently.

Follow the steps to complete the National Rx Security form online

1. Click ‘Get Form’ button to access the online prescription pad order form. This will allow you to view and fill out the required details conveniently.
2. Enter your DEA number in the designated field. Ensure it is accurate as this number is essential for your prescription pads.
3. Input your license number as prompted. This helps verify your professional credentials.
4. Provide your name and degree or clinic name clearly in the specified section.
5. Fill in your specialty, clinic, or hospital name to give context to your order.
6. Enter your street address followed by any suite number, ensuring completeness for delivery purposes.
7. Specify your city, state, and ZIP code accurately, as this information is crucial for processing.
8. Add your NPI number if you want it preprinted on the scripts. Ensure this is correct for efficient processing.
9. Fill in the telephone and fax numbers as needed to facilitate communication regarding your order.
10. Indicate the quantity of scripts you wish to order by circling the appropriate amount and ensuring it matches your needs.
11. If paying by credit card, enter the card number, security code, and expiry date as prompted. Include the address where your credit card statement is sent.
12. Review all entries for accuracy to avoid any processing delays, then save your changes, download, print, or share the completed form as necessary.

Complete your National Rx Security form online today to streamline your prescription pad ordering process.