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Get Doh-2094 2019-2025
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How to fill out the DOH-2094 online
The DOH-2094, or Loss of Controlled Substances Report, is an essential form for reporting incidents of theft, loss, or possible diversion of controlled substances. This guide provides comprehensive, step-by-step instructions on how to complete the form online efficiently.
Follow the steps to accurately fill out the DOH-2094 online.
- Click 'Get Form' button to obtain the form and open it in the editor.
- In the Business Information section, enter the details of your organization, including the business/licensee name, contact name, address, county, and phone numbers. If applicable, provide your BNE License number and select the type of business from the options provided.
- Proceed to the Incident Information section. Check all applicable boxes regarding the nature of the incident and fill in the date and time of the incident, the exact location where the loss or diversion occurred, and details of the law enforcement agency contacted.
- If known, provide information about the suspect, including their name, date of birth, and licensing details. Check the relevant boxes if the suspect is known or if their employment has been terminated.
- Complete the In-Transit Losses section only if the loss occurred during transit. Fill in the names and addresses of both the sender and shipper, along with contact details.
- Attach any supporting documentation relevant to the incident, such as internal reports or police documentation, and describe the incident in detail as required.
- List any controlled substances that were lost or stolen, including their names, monetary value, NDC numbers, and quantities.
- Finally, review your information for accuracy. Confirm the details by completing the signature field, including your printed name, title, and date.
- Once everything is complete, you may save changes, download the form, print a copy, or share it as required. Submit the finished form via email or fax as instructed.
Complete your DOH-2094 form online today to ensure prompt reporting of any incidents.
Related links form
In New York State, a controlled substance refers to drugs that the state regulates due to potential abuse and risk of addiction. This includes substances outlined under guidelines such as DOH-2094. It is essential to know the laws associated with controlled substances for compliance. Tools like US Legal Forms can help you in understanding your responsibilities.
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