24 Del. Admin. Code § 2501-7.0

Current through Register Vol. 28, No. 5, November 1, 2024
Section 2501-7.0 - Mandatory Prescription Form Markers
7.1 Void Pantograph: Outlined open or solid letters spelling the word "VOID" when form is photocopied. A safety VOID pantograph background is required on each design.
7.2 Security Back Print: Text or images on back of forms stating that this is a security script;
7.3 Two signature lines printed at the bottom of the face of the form: Under the first line the words "Substitution Permissible" shall be printed: under the second line the phrase "In order for a brand name product to be dispensed, prescriber must hand write "Brand Necessary" or "Brand Medically Necessary" in the space provided as defined in 24 Del.C. § 2549;
7.4 Watermarking: The back of the form shall contain an artificial watermark reading "Delaware Security Prescription" horizontally in a step-and-repeated pattern in 5 lines, using a 12 point Helvetica bold type style in a coin reactive ink: the words "Delaware Security Prescription" must appear when rubbed with a coin;
7.5 Solid colored background;
7.6 Refill Indicator;
7.7 Chemical Reactive Paper: The paper must react when alteration is attempted using the following list of chemicals: Acetone, Methyl Ethyl Ketone, Nail Polish Remover, Paint Remover, Benzyl Alcohol, Methyl Alcohol, Rubbing Alcohol, Hair Spray, 1-Methoxy-2-Propanol, Carbon Tetrachloride, Bleach;
7.8 List all Security Features on Back;
7.9 Serial Numbered: The numbering scheme shall be in a format that can be easily data entered by the dispensing pharmacy.
7.9.1 Only one copy of serially numbered set shall be produced. NO DUPLICATE OR MISSING NUMBERS ARE ACCEPTABLE
7.10 Heat Sensing (Thermochromic Ink) Imprint.
7.11 Only one Controlled Substance listed on each prescription form.
7.12 Controlled Substance Quantity must be completed in both textual and numeric formats (e.g. #45 forty-five.)

24 Del. Admin. Code § 2501-7.0