Rutgers LAS

Comparative Medicine Resources (CMR)

Controlled Substances

Forms for Controlled Substances record keeping are available for your use.

Name of form

Use
Registrant Information Form Record information for the Registrant (unit or person holding the state and federal permits) Optional Rutgers form.
Authorized Site Information Form Record information for each Authorized Site using the Registrant's registration form. Optional Rutgers form.
Drugs Received Form Registrant  records all incoming drugs for all authorized sites on one form.  Optional Rutgers form. Rev 1/13.
Biennial Inventory Form One form for each Authorized Site. Optional Rutgers form. A Biennial Inventory must be completed at least every 2 years. This is an absolute requirement for DEA. It is recommended to have a signed and dated hardcopy readily available for inspection by DEA. Rev 12/12.
Controlled Substance Log Form One form for each container of drug. Optional Rutgers form.
Controlled Substance Logbook - Sample NEW! The forms above can be used to assemble a readily accesscible record system in one location. This annotated sample logbook has directions for using the forms as well as forms with sample data. Optional Rutgers document.
Controlled Substance Audit Questionnaire NEW! Use this form to conduct a self-audit of your record-keeping and security procedures. Some elements are required. Some are best practices based on interpretation of regulations and feedback from DEA inspections.
Controlled Substance Audit of Drugs Used NEW! Use this form in conjunction with the audit questionnaire to reconcile drugs on hand with your last Biennial Inventory and drug use records.  DEA will perform a similar procedure during inspections.
DEA Form 222 application Preprinted triplicate prescription forms required when ordering Schedule I and Schedule II drugs.
DEA Form 41 Destruction of Controlled Substances (note: see website instructions. Instructions on the form are incorrect.)
NJ Drug Control Unit  
NJ CDS Form DDC-25 (Rev 4/01) The application for a state Controlled Dangerous Substance (CDS) "Researcher" registration is not available on line. The NJ CDS office can be reached at 973 504-6359 but they will ask you to fax a request for an application package to FAX 973 504-6326. In addition to the triplicate DDC-25, you will be sent 9 additional forms and a book of regulations. LAS has forms available in our office.
NJ Controlled Dangerous Substances Statutes  
NJ Controlled Dangerous Substances Regulations  

Laboratory Animal Services maintains a supply of blank state and federal application forms. NJ CDS applications are not available online.

Federal DEA registration forms are available on line at http://www.deadiversion.usdoj.gov/drugreg/reg_apps/index.html. New applicants can complete and submit a DEA Form 225 on line, fill out a form on screen for printing, or print a blank PDF form for printing.

As state employees, registrants are entitled to a waiver of the annual $130 fee for federal registration. This requires a signature attesting that the registrant is a state employee.

 January 9, 2012