Forms for Controlled Substances record keeping are available for your use.
Name of form
|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