Get Nj Sud-a1 2020-2025

The NJ SUD-A1 form is essential for substance use disorder facilities seeking to attest compliance with waiver requirements for medication provision. This guide provides clear, step-by-step instructions to help you complete the form accurately and effectively online.

Follow the steps to successfully fill out the NJ SUD-A1 form online.

1. Click ‘Get Form’ button to obtain the NJ SUD-A1 form and open it in your preferred editor.
2. In the 'Facility Information' section, provide the official name of the facility or program, facility license number, EIN number, site address, city, state, zip, telephone number, and county. Ensure all information is current and accurately reflects the facility.
3. Next, fill out the 'Facility Contacts' section. Include the name and title of the facility administrator or director, their email address, and the contact information for the facility representative who will sign the form.
4. In the compliance attestation section, confirm that the facility meets all necessary conditions outlined in parts I through V. Clearly indicate that the facility has staff licensed in New Jersey and adheres to legal requirements for medication administration.
5. Complete the 'Provision of Services' section by confirming the facility does not prescribe without a proper license, and detail the services offered regarding the treatment of substance use disorders.
6. Fill out the policies and procedures for the facility regarding medication management, including assessments, toxicology screenings, and ensuring continuity of care in case prescribers separate from the facility.
7. Finally, review the 'Medication Storage' section, detailing how medications are stored and managed within the facility, ensuring compliance with Federal and state laws.
8. After you have completed all sections, sign the form as the facility representative, include the date, and ensure all provided information is accurate and complete.

Complete your NJ SUD-A1 form online today for a smooth compliance process.