Get Controlled Substance Application - Nevada State Board Of Pharmacy - Bop Nv

Filling out the Controlled Substance Application is an essential step for individuals seeking to register for controlled substances in Nevada. This guide provides step-by-step instructions to help you complete the application accurately and efficiently.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to obtain the application form and open it in your chosen editor.
2. Begin by entering your personal information. Fill in your first name, middle name (if applicable), and last name. Include your professional degree and practice name (if you have one).
3. Provide your Nevada address. Ensure that you list a valid practicing address; do not use a home address or a P.O. Box. Include suite number if applicable.
4. Complete the fields for your social security number, email address, city, state, and zip code. Make sure to provide a reliable work telephone number.
5. Enter your date of birth and fax number if applicable. Indicate your sex by selecting either ‘M’ for male or ‘F’ for female.
6. Input your practitioner license number and specialty. Remember that a current Nevada license is required for application processing.
7. Respond to the health-related questions honestly. If you have answered ‘yes’ to questions regarding mental illness or criminal charges, provide specified documentation.
8. Certify that all statements made are true and correct. Include your original signature; copies or stamps will not be accepted.
9. Prepare the required fee of $80.00 in the form of a money order or cashier’s check made payable to the Nevada State Board of Pharmacy.
10. Mail the completed application form along with the payment to the address provided at the top of the application. Keep a copy of the application for your records.
11. Upon mailing, wait for a pending registration number before applying to the DEA for authorization to prescribe controlled substances.

Take action now and complete your application online to ensure you are compliant with the Nevada State Board of Pharmacy regulations.