The state of Kentucky currently follows federal requirements for prescription pads as set forth by the CMS. In addition to federal requirements, specific state requirements are as follows:

  • A latent, repetitive “void” pattern screened at five percent in pantone green shall be printed across the entire front of the prescription blank.
  • A water-mark shall be printed on the backside of the prescription blank so that it shall only be seen at a 45-degree angle. The watermark must consist of the words “Kentucky Security Prescription,” and appear horizontally in a step-and-repeated format in 5 lines on the back of the prescription using 12 point Helvetica bold type style.
  • An opaque Rx symbol shall appear in the upper right-hand corner, 1/8 of an inch from the top of the prescription blank and 5/16 of an inch from the right side of the prescription blank. The symbol shall be 3/4 of an inch in size and disappear if the prescription is lightened.
  • Six quantity check off boxes shall be printed on the form and the following quantities shall appear:
    • 1) 1-24
    • 2) 25-49
    • 3) 50-74
    • 4) 75-100
    • 5) 101-105
    • 6) 151 and over;
  • The following statement shall be printed on the bottom of the prescription blank: “Prescription is void if more than one prescription is written per blank.”
  • A quantity check-off box that corresponds to the quantity prescribed shall be marked

State Requirements

All states are required to meet the baseline standards set forth by the CMS. Several states have Prescription Monitoring Programs that require prescription pads to have specific security features.

For in-depth information regarding specific state requirements choose from the list below.


View Our Prescription Pad Sell Sheet

PDF Download