Get Request For Approval Of Disposal/destruction Of Controlled ... - Health Ny

Filling out the Request For Approval Of Disposal/Destruction Of Controlled Substances form is a crucial process for ensuring compliance with legal regulations regarding controlled substances. This guide aims to provide clear and concise instructions for completing the form online.

Follow the steps to effectively complete the online disposal request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out Section I -- Request Information. Ensure you print or type all required information clearly. This includes entering your requestor name, street address (including a physical address if using a P.O. Box), city, state, county, and telephone number.
3. Input your Controlled Substance License number or your DEA registration number if not subject to Article 33 licensure. Schedule the date of disposal/destruction and indicate the method you will use to dispose of the controlled substances.
4. In the Personnel Conducting Disposal/Destruction section, list the names and titles of the individuals who will handle the disposal or destruction. Each individual must provide their professional license number.
5. Complete the Requestor Affirmation section by affirming the intention to follow applicable laws in the disposal process. Provide your name, title, signature, and date.
6. Once the disposal/destruction has been completed, Section II must be filled out. Ensure that the personnel who conducted the disposal sign and date the form.
7. Finally, review all entries to ensure accuracy. Save changes, then download or print the form as needed for your records or submission.

Ensure your compliance and submit the Request For Approval Of Disposal/Destruction Of Controlled Substances form online today.