Get Gapdmp

The Gapdmp online form is designed for patients to request their personal data from the Georgia Prescription Drug Monitoring Program. This guide will walk you through each section of the form to ensure a smooth and efficient completion process.

Follow the steps to successfully fill out the Gapdmp online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin filling out the patient information section. Enter the applicant's full name, address, city, state, zip code, phone number, and email address as prompted. Ensure all information is accurate and legibly typed or printed.
3. Provide the driver's license number and date of birth in the specified formats (MM/DD/YYYY). This information is essential for verifying your identity.
4. Indicate the reporting period by entering the 'From' and 'To' dates. These dates should represent the range of time for the prescription information you are requesting.
5. Include your signature in the designated section to confirm your request. This signature serves as your authorization for the data release.
6. If applicable, complete the attorney section by entering the attorney's name, address, city, state, zip code, phone number, email address, and driver’s license number.
7. Ensure the attorney also signs the form if they are submitting the request on your behalf.
8. Once all sections are completed, prepare to submit the form alongside two forms of government-issued identification by mailing it to the provided address marked ATTN: GAPDMP.
9. Finally, you can save changes to your completed form, download a copy for your records, print it, or share it as needed.

Submit your Gapdmp request online today for timely access to your prescription data.