The Epson driver for Windows will be the one that controls the paper size.

For most users, you'll see the A5 paper size by default.

You can double check it by heading to Hardware and Sound > Devices and Printers

Then double click on the Epson printer icon.

You should see the A5 option there.

  • Before printing a prescription inside SeriousMD, load the half bond paper (5.5x8.5) OR A5 paper to your printer.
  • Move the paper guide so it fits the paper exactly


  • Pick A5 as the paper size in the popup (Example below is for Chrome)
  • Print it out! Sign the prescription and you are done!

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If you do not see the A5 option or in a rare printer-specific issue that causes your A5 option to get cut-off, please do the following steps.

  • In the Devices and Printers area, double click on your printer icon
  • Once inside, you will see this. Click the Paper link shown in the image below.
  • For the document size, click on User-Defined
  • Add a paper size name
  • Set paper width to 5.5 
  • Set paper height to 8.5
  • Set unit to inches
  • Click on Save
  • Print a prescription and select the paper size  you just created.
  • Print it out and it should look like this.


Note: Apologies for the screenshots. This is just to show you that we actually did each step and that it really works.

Here's how to Add a Custom Paper size On a Mac:

  1. If you are using Safari, press Command + P
  2. If you are using Chrome, press Command + Option + P
  3. On the pop up, click on Paper size -> Pick Manage Custom Sizes

4. On the next popup, click +
5. Give the paper size a name
6. In the paper size field, put 140 mm in Width and 216 mm in Height
7. Press OK

8. Now when you print, you can pick the paper size that you just created. If you are using Google Chrome to print, please press Command + Option + P instead of the usual Command + P

PS. If you are wondering about creating a custom design for your prescription, here's how to do it.

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