Follow the steps to successfully complete the Doh Form

1. Click the ‘Get Form’ button to obtain the Doh Form, and open it in the online editor.
2. Fill in the applicant's name, including the last name, first name, and middle initial in the designated fields.
3. Specify your profession and include your New York State license number.
4. If applicable, enter your DEA registration number. If you do not hold a DEA number, proceed to complete the affirmation section.
5. Provide your NPI number in the corresponding area, if you have one.
6. Enter your address as it appears on your DEA registration if you are DEA registered. If not, enter the address of your primary practice office.
7. Fill in the city, state, and zip code fields accurately. Ensure the zip code is for your listed address.
8. Include your most recent fax number and/or business email address for communication with the Bureau.
9. Input your phone number in the designated area, including the area code.
10. Affirm the accuracy of your statements by signing the form in original ink, and write the date of signing.
11. If you are a practitioner without a DEA number, fill out the acknowledgment section, which requires a notary signature and stamp.
12. Once you have completed the form, you can save your changes, download the filled form, print it, or share it as needed.

Begin your registration process by filling out the Doh Form online today.