Are Your Prescription Forms Compliant?

The Medical Board of California (Board) has received inquiries from physicians regarding some pharmacies refusing to fill prescriptions written on non-compliant prescription forms. The Board urges physicians to verify their prescription forms are compliant with state law prior to using the form.

Since July 2012, California Health and Safety Code Section 11162.1 requires 14 elements to appear on California Security Prescription Forms, the forms which replaced the triplicate prescription form. State law also requires California Security Prescription Forms to be produced by printers licensed by the California Department of Justice (California Security Prescription Printers Program).

Pursuant to California law, prescription forms for controlled substances must be printed with the following features:

  1. A latent, repetitive “void” pattern across the entire front of the prescription blank; if a prescription is scanned or photocopied, the word “void” shall appear in a pattern across the entire front of the prescription.
  2. A watermark on the backside of the prescription blank; the watermark shall consist of the words “California Security Prescription.”
  3. A chemical void protection that prevents alteration by chemical washing.
  4. A feature printed in thermochromic ink.
  5. An area of opaque writing so that the writing disappears if the prescription is lightened.
  6. A description of the security features included on each prescription form.
  7. (A) Six quantity check off boxes on the form so that the prescriber may indicate the quantity by checking the applicable box where the following quantities shall appear:
    • 1–24
    • 25–49
    • 50–74
    • 75–100
    • 101–150
    • 151 and over.
    (B) In conjunction with the quantity boxes, a space shall be provided to designate the units referenced in the quantity boxes when the drug is not in tablet or capsule form.
  8. Prescription blanks shall contain a statement printed on the bottom of the prescription blank that the “Prescription is void if the number of drugs prescribed is not noted.”
  9. The preprinted name, category of licensure, license number, federal controlled substance registration number, and address of the prescribing practitioner.
  10. Check boxes on the form so that the prescriber may indicate the number of refills ordered.
  11. The date of origin of the prescription.
  12. A check box indicating the prescriber’s order not to substitute.
  13. An identifying number assigned to the approved security printer by the Department of Justice.
  14. A check box by the name of each prescriber when a prescription form lists multiple prescribers.
(Source: California Health & Safety Code Section 11162.1.)

Interim Solutions for Prescribers:

  • Prescribers and dispensers need to immediately verify they are using compliant prescription forms that contain all of the elements listed above.
  • Prescribers with non-compliant forms should re-order compliant forms from a DOJ-licensed security printer. Prescribers should verify that the form contains all of the elements listed above before purchase. The DOJ Approved List of Security Prescription Printers is available here.
  • Prescribers with non-compliant forms should consider using e-prescribing for controlled substances.


  • Schedule III through V controlled substances may be filled (and refilled) if the pharmacist treats the prescription as an oral prescription and verifies orally with the prescriber the number of any refills ordered with notations on the security form. See Health and Safety Code section 11200 for more information.
  • California law provides that Schedule II drugs cannot generally be orally prescribed, nor can they be refilled using a California Security Prescription. However, when there is no alternative except to prescribe a Schedule II controlled medication using a non-compliant California Security Form to allow patients to receive their pain medications timely, prescribers and dispensers should communicate about why a non-compliant California Security Form is being used on a temporary basis. See Health and Safety Code section 11200 for more information.
  • There are exceptions in some cases that allow other ways to prescribe California Health and Safety Code sections 11159.2 for terminally ill and 11162.1(c) for health care facilities with 25 or more physicians.