Doh 2340-2025

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52 votes

The document is a request form for the approval of the disposal or destruction of controlled substances, issued by the New York State Department of Health's Bureau of Narcotic Enforcement. It outlines the necessary information required for submission, including details about the licensee, method of disposal, and personnel involved. The form emphasizes compliance with federal, state, and local laws and specifies that disposal must occur on weekdays during designated hours. It also includes sections for affirmation and post-disposal confirmation.

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Click ‘Get Form’ to open the doh 2340 in the editor.
Begin by filling out SECTION I – REQUEST INFORMATION. Enter your Licensee Name, ensuring to include a street address if using a P.O. Box. Complete the fields for Street, City, State, County, Telephone, Email Address, Zip, and Fax.
Input your Controlled Substance License # or DEA registration number if applicable. Specify the Date of Disposal/Destruction and select an appropriate Start Time (AM/PM).
Detail the Method of Disposal/Destruction and provide the Location of Disposal/Destruction including room number or name.
Have the Personnel Conducting Disposal/Destruction fill in their Name, Title, and Professional License #.
In the REQUESTOR AFFIRMATION section, affirm that you will dispose of/destroy controlled substances as proposed by signing and dating the form.
After disposal/destruction is completed, complete SECTION II by having personnel sign and date to confirm compliance with regulations.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (52 Votes)
2010	4.4 Satisfied (326 Votes)

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What are controlled substance drugs?

In the United States, is a Schedule 2 controlled substance. This is because experts define it as a drug with a high potential for misuse that could lead to severe psychological or physical dependence.

What information must be included in disposal records for controlled substances?

A usage and disposal log must contain the following information: DEA Registrant. Approved IACUC Protocol #s. CS Name. CS Stock Container ID # All individual CS containers must have a unique alphanumeric ID (e.g., A-1, B-1, C-1, etc.) CS Storage Location. Amount Received. Date of Receipt. Expiration Date.

What is a DEA form 41 used for?

PURPOSE: To document the surrender of controlled substances which have been forwarded by registrants to DEA for disposal. ROUTINE USES: This form is required by Federal Regulations for the surrender of unwanted Controlled Substances.

What drugs are on the controlled substance list?

Schedule I Controlled Substances Some examples of substances listed in Schedule I are: , lysergic acid diethylamide (LSD), marijuana (cannabis), , methaqualone, and 3,4-methylenedioxymethamphetamine (Ecstasy).

Does New York require a controlled substance license?

Businesses that manufacture, distribute, or use controlled substances need a license. This license is from the New York State Department of Health (NYSDOH). Controlled substances are defined under federal law. They include opioids, methamphetamines, marijuana, alcohol products, hallucinogenic drugs and other narcotics.

Is coke considered a controlled substance?

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are: , lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and .

Doh 2340-2025

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