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Get Request Report - Division Of Professional Regulation - State Of ...
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How to fill out the Request Report - Division Of Professional Regulation - State Of Delaware online
Filling out the Request Report for the Division of Professional Regulation is a crucial step for law enforcement officials seeking prescription monitoring program data. This guide provides clear, accessible instructions to assist you in completing the form accurately and efficiently online.
Follow the steps to successfully complete your request report online.
- Click ‘Get Form’ button to access the request report and open it in your preferred document editor.
- Begin by completing the 'Requesting Official' section. This includes entering your name, title, agency name, contact information, and case number. Ensure all fields are filled as they are required.
- Initial the attestation statements to confirm your status as a requesting official engaged in relevant investigations. Make sure that your attestations are true and correct.
- In the 'Information About Investigation' section, describe the criminal activity under investigation and list details of each crime. Decide whether identifying patient data is needed and provide justification if necessary.
- Fill out the 'Report Details' section, including the date range for the report and the specific PMP profile (patient or prescriber) you are requesting.
- If requesting a patient profile, complete the 'Patient Information' section with all necessary details. For prescriber profiles, fill in the prescriber's name and DEA numbers.
- Select your preferred report delivery option, ensuring that you indicate if you require secure email or certified mail.
- Read the certification statement regarding HIPAA and confidentiality. Confirm your understanding by signing the form in the designated areas for both you and your supervisor.
- Once all sections are completed, save your changes, and prepare to submit your request either via secure email or regular mail as per the provided instructions.
Complete your Request Report online today to ensure timely processing of your prescription monitoring program data.
Professional and occupational regulation is predominantly a state function, undertaken and protected under Article X of the U.S. Constitution. Article X grants states the authority to regulate activities affecting the health, safety and welfare of their citizens.
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