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- Click ‘Get Form’ to open the Application for Indiana Controlled Substances Registration in our editor.
- Begin by selecting your professional category from the options provided, such as Dentist, Physician, or Veterinarian. This helps tailor the application to your specific needs.
- Fill in your personal details including your name, date of birth, and Social Security number. Ensure accuracy as this information is mandatory for processing.
- Provide your contact information including telephone number and email address. This will facilitate communication regarding your application status.
- Indicate the Indiana practice address where you will be operating. Remember, a PO Box is not acceptable.
- Check all applicable drug schedules that pertain to your practice. This section is crucial for compliance with state regulations.
- If applicable, answer the questions regarding past compliance issues truthfully. If you answer 'Yes' to any question, prepare a signed and notarized statement explaining the circumstances.
- Finally, affirm the accuracy of your application by signing and dating it at the bottom before submitting it through our platform.
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