Get Nar 78a Form

Filling out the Nar 78a Form online is a straightforward process that allows applicants to register for controlled substances efficiently. This guide provides step-by-step instructions on how to accurately complete the form and submit it online.

Follow the steps to fill out the Nar 78a Form online successfully

1. Press the ‘Get Form’ button to access the Nar 78a Form. This will open the document in your preferred editing tool, allowing you to fill it out online.
2. Begin by entering the applicant or provider’s representative name as listed on the relevant forms NAR-77, NAR-77A, NAR-77B, NAR-78, NAR-78A, or NAR-78B.
3. Input the correct email address where you can be reached.
4. If applicable, include your current Controlled Substance Registration (CSR) number, board license number, federal (DEA) registration number, and National Provider Identifier (NPI).
5. Fill in the expiration dates as required for each registration or identifier provided.
6. In the Government Unit Information section, state the name of the governmental unit by which you are employed, such as a health service or hospital.
7. Complete the business address section with your physical address—ensure not to use a P.O. Box.
8. Provide the city, state, ZIP code, and county for the location of your employment.
9. Carefully read the verification statement and ensure that all information is true and accurate; remember that false statements may lead to prosecution.
10. Enter the date of signing the document.
11. Sign the form in the designated area where it states, 'Signature of Applicant.' Ensure that only necessary individuals, such as administrators or designated approvers, sign the document.
12. If applicable, the certifying supervisor must print their name, official title, and sign where indicated. They too must avoid using stamped signatures.
13. Finally, include the certifying supervisor’s phone number and email address.
14. Once you have reviewed all entries for accuracy, save your changes, and choose your preferred method for submitting the form: via online secured email, fax, or by mail as specified in the instructions.

Start completing the Nar 78a Form online today to ensure your controlled substances registration is processed promptly.