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How to fill out the Cspmp Form online
Filling out the Cspmp Form online can streamline your application process for accessing the Arizona Controlled Substances Prescription Monitoring Program. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to successfully complete the Cspmp Form online.
- Press the ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin with the 'Demographics' section. Enter your legal first name, middle name, and legal last name. Fill in the last four digits of your Social Security Number and your date of birth using the format MM/DD/YYYY.
- Next, move to the 'Practice Address' field. Provide your street address in line one and, if necessary, in line two. Then, input your city, state, work phone number, zip code, and county. If you have a fax number, include that as well.
- Indicate whether your mailing address is the same as your practice address by checking the appropriate box.
- If your mailing address differs, complete the 'Mailing Address' section with the required details, including street address, city, state, zip code, and county.
- Enter your work or personal email address in the designated field. It is important to ensure this is an address you have regular access to.
- If you hold multiple DEA numbers, remember that you must complete a separate form for each number.
- Finally, review your entries for accuracy. Once you have confirmed that all information is correct, you can save changes, download, print, or share the form as needed.
Complete your forms online today to ensure a smooth application process.
What information does the PMP provide? Schedules II-V controlled substance prescription information. Records viewable for 12 months and kept on record for two years.
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