Download
Printable Order Form
Single-Part
Standard-Size Pads
|
No. of
Pads
|
No. of
Scripts
|
Price
Per Pad
|
Total
Price
|
|
1
|
100
|
$53.90
|
$53.90
|
|
4
|
400
|
$19.95
|
$79.80
|
|
5
|
500
|
$16.85
|
$84.25
|
|
8
|
800
|
$13.30
|
$106.40
|
|
10
|
1000
|
$10.90
|
$109.00
|
|
20
|
2000
|
$9.95
|
$199.00
|
|
25
|
2500
|
$9.90
|
$247.50
|
|
40
|
4000
|
$6.95
|
$278.00
|
|
50
|
5000
|
$6.90
|
$345.00
|
|
60
|
6000
|
$6.80
|
$408.00
|
|
80
|
8000
|
$6.65
|
$532.00
|
Two-Part
Standard-Size Pads
|
No. of
Pads
|
No. of
Scripts
|
Price
Per Pad
|
Total
Price
|
|
1
|
50
|
$66.55
|
$66.55
|
|
4
|
200
|
$26.00
|
$104.00
|
|
5
|
250
|
$21.80
|
$109.00
|
|
8
|
400
|
$15.15
|
$121.20
|
|
10
|
500
|
$13.30
|
$133.00
|
|
20
|
1000
|
$10.40
|
$208.00
|
|
25
|
1250
|
$10.30
|
$257.50
|
|
40
|
2000
|
$8.70
|
$348.00
|
|
50
|
2500
|
$8.60
|
$430.00
|
|
60
|
3000
|
$8.50
|
$510.00
|
|
80
|
4000
|
$8.00
|
$640.00
|
Single-Part
Large Size Pads
|
No. of
Pads
|
No. of
Scripts
|
Price
Per Pad
|
Total
Price
|
|
1
|
100
|
$78.65
|
$78.65
|
|
5
|
500
|
$36.30
|
$181.50
|
|
10
|
1000
|
$23.60
|
$236.00
|
|
20
|
2000
|
$16.40
|
$328.00
|
|
25
|
2500
|
$16.30
|
$407.50
|
|
40
|
4000
|
$13.25
|
$530.00
|
|
50
|
5000
|
$12.50
|
$625.00
|
Two-Part
Large-Size Pads
|
No. of
Pads
|
No. of
Scripts
|
Price
Per Pad
|
Total
Price
|
|
1
|
50
|
$90.75
|
$90.75
|
|
5
|
250
|
$42.35
|
$211.75
|
|
10
|
500
|
$24.80
|
$248.00
|
|
20
|
1000
|
$17.80
|
$356.00
|
|
25
|
1250
|
$17.70
|
$442.50
|
|
40
|
2000
|
$14.60
|
$584.00
|
|
50
|
2500
|
$13.75
|
$687.50
|
Laser
& Ink Jet Compatible Forms
|
No. of
Forms
|
Total
Price
|
|
100
|
$95.70
|
|
500
|
$156.20
|
|
1000
|
$240.90
|
|
2500
|
$482.90
|
|
5000
|
$845.90
|
|
10000
|
$1,208.90
|
