(a) The prescription forms for controlled substances shall be printed with the following features:

1. (1) A latent, repetitive “void” pattern shall be printed 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. (2) A watermark shall be printed on the backside of the prescription blank; the watermark shall consist of the words “California Security Prescription.”
3. (3) A chemical void protection that prevents alteration by chemical washing.
4. (4) A feature printed in thermochromic ink.
5. (5) An area of opaque writing so that the writing disappears if the prescription is lightened.
6. (6) A description of the security features included on each prescription form.

7. (7)

   1. (A) Six quantity check off boxes shall be printed 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.

   2. (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. (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. (9) The preprinted name, category of licensure, license number, federal controlled substance registration number, and address of the prescribing practitioner.
10. (10) Check boxes shall be printed on the form so that the prescriber may indicate the number of refills ordered.
11. (11) The date of origin of the prescription.
12. (12) A check box indicating the prescriber’s order not to substitute.
13. (13) An identifying number assigned to the approved security printer by the Department of Justice.

14. (14)

    1. (A) A check box by the name of each prescriber when a prescription form lists multiple prescribers.
    2. (B) Each prescriber who signs the prescription form shall identify themselves as the prescriber by checking the box by the prescriber’s name.
15. (15) A uniquely serialized number, in a manner prescribed by the Department of Justice in accordance with Section 11162.2.

(c)

1. (1) A prescriber designated by a licensed health care facility, a clinic specified in Section 1200, or a clinic specified in subdivision (a) of Section 1206 that has 25 or more physicians or surgeons may order controlled substance prescription forms for use by prescribers when treating patients in that facility without the information required in paragraph (9) of subdivision (a) or paragraph (3).
2. (2) Forms ordered pursuant to this subdivision shall have the name, category of licensure, license number, and federal controlled substance registration number of the designated prescriber and the name, address, category of licensure, and license number of the licensed health care facility the clinic specified in Section 1200, or the clinic specified in Section 1206 that has 25 or more physicians or surgeons preprinted on the form. Licensed health care facilities or clinics exempt under Section 1206 are not required to preprint the category of licensure and license number of their facility or clinic.
3. (3) Forms ordered pursuant to this section shall not be valid prescriptions without the name, category of licensure, license number, and federal controlled substance registration number of the prescriber on the form.

4. (4)

   1. (A) Except as provided in subparagraph (B), the designated prescriber shall maintain a record of the prescribers to whom the controlled substance prescription forms are issued, that shall include the name, category of licensure, license number, federal controlled substance registration number, and quantity of controlled substance prescription forms issued to each prescriber. The record shall be maintained in the health facility for three years.
   2. (B) Forms ordered pursuant to this subdivision that are printed by a computerized prescription generation system shall not be subject to subparagraph (A) or paragraph (7) of subdivision (a). Forms printed pursuant to this subdivision that are printed by a computerized prescription generation system may contain the prescriber’s name, category of professional licensure, license number, federal controlled substance registration number, and the date of the prescription.

(d) Within the next working day following delivery, a security printer shall submit via web-based application, as specified by the Department of Justice, all of the following information for all prescription forms delivered:

1. (1) Serial numbers of all prescription forms delivered.
2. (2) All prescriber names and Drug Enforcement Administration Controlled Substance Registration Certificate numbers displayed on the prescription forms.
3. (3) The delivery shipment recipient names.
4. (4) The date of delivery.