Doh 3848-2026

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  1. Click ‘Get Form’ to open the doh 3848 in the editor.
  2. Begin by entering your Agency Name, NYS Agency Code, and NYS CS License No. in the designated fields. Ensure accuracy as these details are crucial for identification.
  3. Fill in your Business Phone, Address, City, State, County, and Zip code. This information helps in verifying your agency's location.
  4. List each Controlled Substance you are reporting. For each substance, specify the Dosage Form (mg/unit) and provide the Total Quantity Received from DEA Registrant.
  5. Document the Total Quantity Administered and Wasted, along with the Total Quantity Lost. If applicable, attach DOH-2094 for losses.
  6. Complete the Physical Inventory Count for stocks and sub-stocks and indicate the Total Number of EMS Responders authorized to administer controlled substances.
  7. Finally, certify your report by signing as both Agent and CEO, including dates before submitting it to the New York State Department of Health.

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