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DEA COMPLIANCE FORM - Penn Veterinary Supply

DEA COMPLIANCE FORM - Penn Veterinary Supply 2026

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4.9 out of 5

32 votes

The document is a credit application form for veterinary practices seeking to establish an account with Penn Veterinary Supply, Inc. It includes sections for account information, fax permission, online ordering access, and an agreement outlining the terms of service. Additionally, it contains specific requirements for Florida customers regarding the Health Care Clinic Establishment (HCCE) permit necessary for purchasing prescription drugs. The form also gathers customer profile information and preferences related to product ordering and communication.

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Click ‘Get Form’ to open it in the editor.
Begin with Section 1: ACCOUNT INFORMATION. Fill in your Legal Name, Veterinarian’s Name, and Practice Name. Ensure that all addresses are accurate, including mailing and shipping details.
Provide your contact information, including phone number and email address. Specify the Accounts Payable Contact and Purchasing Contact for efficient communication.
In Section 2: FAX PERMISSION, indicate whether you consent to receive faxes from Penn Veterinary Supply by signing where indicated.
Proceed to Section 3: ONLINE ORDERING ACCESS. Select if you would like online ordering access and provide your signature along with printed name and title.
Finally, complete Section 4: AGREEMENT by signing and providing necessary identification numbers such as Social Security Numbers and Federal DEA License Number.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (32 Votes)
2018	4.3 Satisfied (175 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Who sends a copy of 222 to DEA?

Any supplier who is not required to report acquisition/disposition transactions to the Automation of Reports and Consolidated Orders System (ARCOS) under 1304.33(c) (such as a practitioner) must make and submit a copy of the original DEA Form 222 to DEA, either by mail to the Registration Section, or by email to DEA.

What is DEA form 224 used for?

DEA Form 224: Application for Registration Under the Controlled Substances Act. This is the form pharmacies use to apply for a new registration with the DEA to dispense controlled substances. Its a crucial step for any pharmacy before beginning operations involving controlled substances.

How do I get a copy of my DEA certificate?

Request Copy of DEA Certificate For these matters call 1-800-882-9539; for change of address, use the Address Changes Form.

Where to get DEA form 222?

DEA 222 forms are available to active registrants at no charge. DEA 222 forms may be ordered by calling: DEA Headquarters Registration Unit toll free at 800-882-9539.

What is the DEA form?

When the Drug Enforcement Administration (DEA) grants the Registrant permission to use Schedule I or II (C-I or C-II) drugs they will send DEA Form 222 order forms. The Registrant* is responsible for securing Forms 222 and retaining copies of the executed and the original unexecuted forms.

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How to get a DEA form 222?

Any person holding a registration authorizing the person to obtain a DEA Form 222 may requisition the forms through a DEA secured network connection or by contacting any Division Office or the Registration Section of the Administration through the customer service center.

What is a DEA form 222?

The Drug Enforcement Administration (DEA), Office of Diversion Control, will accept requests from distributors that require a large volume of Order Forms (DEA Form 222) with the pin feed tracking left on the form. Order Forms are used for the distribution of a Schedule I or II controlled substance.

How to get a DEA certificate?

How to obtain a DEA license Meet state licensing requirements. Before you apply for your DEA license, you can ensure that you meet your states licensing requirements to practice medicine. Apply for DEA registration. After meeting your state requirements, you can apply for DEA registration. Pay the application fees.

DEA COMPLIANCE FORM - Penn Veterinary Supply 2026

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