Get Dps Csrfee

The Dps Csrfee form is essential for individuals seeking to register as mid-level practitioners handling controlled substances. This guide offers a clear step-by-step approach to filling out the form online, ensuring that users provide all necessary information accurately.

Follow the steps to complete your application efficiently.

1. Press the ‘Get Form’ button to access the Dps Csrfee and open it in your preferred editor.
2. Fill in the application type by selecting one of the options: New Registration, Additional Registration, Renew Existing Registration, or Re-application. If renewing, ensure to provide the registration number and the expiration date.
3. Complete the applicant information section with your last name, first name, middle name, suffix, degree, social security number, email address, current board license number, and its expiration date. Additionally, provide your current federal registration number, if applicable.
4. Input your business address, including physical address, city, state, and ZIP code. Also, select the type of phone number you are providing: office, cell, or home, and fill in the corresponding phone number.
5. In the supervising physician information section, fill in their last name, first name, middle name, suffix, degree, medical board number, and their CSR number. Indicate whether the physician is registered with the Texas Medical Board.
6. Select all applicable drug schedules from the options provided, confirming the prescriptive authority delegation for those schedules.
7. Answer the liability questions truthfully, providing additional information or letters as necessary regarding any prior convictions or actions against previous registrations.
8. Indicate whether the exemption of fee applies and provide verification of the information. Ensure to sign and date the application, as no stamped signatures are accepted.
9. Once all sections are completed, double-check for accuracy, then save your changes. You may then download, print, or share the completed form as required.

Complete your Dps Csrfee application online today.