Get Reinstatement Application - State Of New Jersey - Njconsumeraffairs

This guide provides a clear, step-by-step approach to completing the Reinstatement Application for the New Jersey Controlled Dangerous Substance registration. Whether you are a healthcare provider or mid-level practitioner, our instructions will help you navigate the process with confidence.

Follow the steps to successfully complete your reinstatement application online.

1. Press the ‘Get Form’ button to access the application form and open it in your preferred editor.
2. Begin with Section A. Complete all items, including the applicant’s name, place of business, and contact information. Ensure to provide an actual location instead of just a P.O. box.
3. Provide the reinstatement fee amount as indicated in the instruction sheet. Be sure to enclose a check or money order made payable to the 'State of New Jersey.'
4. Indicate the type of registration requested for Schedules II through V, specifying any particular schedules as required.
5. Answer the questions regarding any restrictions, criminal history, or pending charges truthfully. Attach a letter of explanation if responding 'yes' to any inquiries.
6. Fill out Section B, selecting the appropriate category for dispenser/prescriber.
7. In Section C, provide your active New Jersey license number, affirm the required oversight for mid-level practitioners, and disclose your Social Security number as requested.
8. Complete Section D by signing the affidavit and having it notarized. Ensure all information is truthful to avoid any legal issues.
9. Retain a copy of the application for your records. Once completed, mail the original application and a copy along with your fee to the specified address.

Take control of your professional status by completing your reinstatement application online today!