Request for Exemption from Reporting - Minnesota PDMP 2025

See details

4.4 out of 5

46 votes

The document is a request form for exemption from reporting to the Minnesota Prescription Monitoring Program (PMP). It outlines the categories of patients eligible for exemption, such as those in skilled nursing facilities or receiving hospice care. The form requires certification and includes sections for the pharmacy or facility's details and a signature.

Here's how it works

01. Edit your minnesota pdmp online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Request for Exemption from Reporting - Minnesota PDMP with DocHub

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by checking the appropriate boxes that apply to your patients. You can select multiple categories, such as individuals in skilled nursing facilities or those receiving hospice care.
If applicable, indicate if you represent a pharmacy or facility that never dispenses controlled substance prescriptions by checking the corresponding box.
In the comments section, provide any additional information that may support your request for exemption.
Complete the certification statement by signing and providing your title, printed name, email address, and pharmacy or facility details including license number and contact information.

Start using our platform today to easily complete your Request for Exemption form online for free!

See more Request for Exemption from Reporting - Minnesota PDMP versions

We've got more versions of the Request for Exemption from Reporting - Minnesota PDMP form. Select the right Request for Exemption from Reporting - Minnesota PDMP version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2021	4.4 Satisfied (28 Votes)
2010	4.4 Satisfied (46 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

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.

Is a controlled substance in Minnesota?

All written prescriptions (or printed on paper and given to the patient or an agent of the patient or that is transmitted by fax) must be manually signed on the day issued by the prescriber. An electronic prescription must contain the prescribers electronic signature.

Is it illegal to carry prescription drugs without the bottle in Minnesota?

*Due to state regulations Allivet cant ship to the following states AL, CT, DC, IL, IN, KS, KY, LA, MA, MN, MS, NC, ND, NE, NJ, OH, OR, TN, UT, VA, WI, WV, WY.

What is considered a controlled substance in MN?

Drugs deemed controlled substances include: and Methamphetamine. . Amphetamines, , and Hallucinogens (i.e. LSD)

What are the rules for prescriptions in Minnesota?

Proof of Prescription Someone with a prescription must carry their medication in the proper bottle with the official label on it. Failing to do so could lead to prescription drug charges and a criminal arrest, and a person may receive a label violation even if they prove their prescription to law enforcement later on.

What states is a controlled substance in?

As of July 2022, these states consider a schedule V controlled substance: Alabama. Kentucky. Michigan. North Dakota. Tennessee. Virginia. West Virginia.

What type of narcotic is ?

is not a narcotic. Its not classified as a controlled substance in most states. (Kentucky, West Virginia, Michigan, Tennessee, and Virginia have reclassified as a Schedule V controlled substance). is not an opioid.

Request for Exemption from Reporting - Minnesota PDMP 2025

Here's how it works

How to use or fill out Request for Exemption from Reporting - Minnesota PDMP with DocHub