New Jersey Is An Equal Opportunity Employer . Printed on Recycled Paper and Recyclable
November 2010
Dear Printer Vendors,
On February 16, 2010, the Division of Consumer Affairs published a Notice in the New Jersey Register
soliciting comments on possible amendments to the printing specifications for New Jersey Prescription
Blanks (NJPBs). Specifically, the Notice invited comment on various security features the Division is
considering to make the blanks more secure and to reduce the likelihood of prescription forgeries. As an
approved printer vendor in the NJPB program, the Division appreciates your expertise and invites you to
review the enclosed Notice and to submit any comments you may have on this subject by December 20, 2010.
The Division may also contact you in the near future to arrange a meeting to discuss security measures for
I am also advising you of recent statutory amendments to the NJPB law that may have an impact upon
printing specifications for certain practitioners. P.L.
2009, c. 297, which became effective on July 17, 2010,
permits practitioners and health care facilities utilizing electronic health record programs to imprint the
practitioner’s name and license number or unique provider number on NJPBs. All other information required
by the Division’s regulations (N.J.A.C
. 13:45A-27.1 et seq.) to appear on the NJPBs must continue to be pre-
printed on the prescription blanks.
Under the new law, practitioners may request NJPBs that are pre-printed without the practitioner’s name,
address and/or NPI number only if the practitioner uses an electronic health records system. As a result, the
Division requests that prior to printing such blanks for a practitioner, you document that the practitioner has
an electronic health records program. To that end, the Division has created a short form for you to use for this
purpose, which is available on the Division’s website at
When a practitioner requests NJPBs pre-printed without his or her name, address and/or NPI, please use this
form to obtain from the practitioner the name and manufacturer of the electronic health records program he or
she uses. Please maintain this information on file with the practitioners’ records.
Thank you for your anticipated cooperation in this matter, and I look forward to receiving your comments on
the enclosed Notice.
Lawrence DeMarzo,
Deputy Director
Division of Consumer Affairs
Office of the Director
124 Halsey Street, 7
Floor, Newark NJ
Lt. Governor
Attorney General
Acting Director
Mailing Address:
P.O. Box 45027
Newark, NJ 07101
New Jersey Prescription Blank
Electronic Health Records Program
Prescriber Confirmation
Please use this form to document the electronic health records program used by a
prescriber who requests New Jersey Prescription Blanks that are pre-printed without the
prescriber’s name, address and/or NPI number
Prescriber Information
Name: _________________________________________
License Number:_________________________________
Address: _______________________________________
Electronic Health Records Program Information
Name of Program:________________________________
Manufacturer: ___________________________________