Get Ia 588-8109 2016-2025

Filling out the IA 588-8109 form for renewal or change of Iowa controlled substances registration is a crucial task for practitioners and businesses in Iowa. This guide provides step-by-step instructions to ensure you complete the form accurately and efficiently while submitting it online.

Follow the steps to complete the IA 588-8109 form online.

1. Click the ‘Get Form’ button to access the IA 588-8109 online form and open it in the designated editor.
2. In section 1, indicate whether you are applying for renewal or change and specify the nature of the change if applicable. Enter your state CSA registration number and expiration date.
3. In section 2, fill in your name and mailing address unless it is the same as your practice address. Note that an alternate address is not available for pharmacy or hospital registration.
4. In section 3, complete the registration fee section by confirming the amount of $90. Make sure to review the submission method for payment, which should be a check or money order addressed to the Iowa Board of Pharmacy.
5. Provide your Iowa practice or business address, ensuring it is not a PO Box. Fill in both sections with your business name and address details, as well as the city, state, and zip code.
6. Fill in your email address and business phone number in section 4.
7. Complete section 6 by entering your Federal DEA number and include your Iowa professional license number in section 7.
8. In section 8, check the schedules according to which you intend to handle controlled substances including their categories, such as narcotics and non-narcotics.
9. In section 9, provide the name and title of the responsible individual authorized to sign the Federal Controlled Substances Order Form 222.
10. Answer the mandatory questions in section 10. If the applicant is an individual, respond accordingly; if a corporation or partnership, address those queries as fitted.
11. In the event of answering 'yes' to any questions in section 10, provide an explanation in the space provided on the reverse side of the application.
12. Complete the applicant's personal information in section 11, including the date of birth and social security number if applicable.
13. Finally, review all entries for accuracy. After confirming everything is correct, you can save changes, download, or print the form for submission.

Complete your IA 588-8109 form online today to ensure compliance with Iowa regulations.