Narcotic Enforcement Forms
Official Prescription Program
- Letter to Practitioners
- Registration/Renewal Form for Official NYS Prescription Program (PDF, 40KB, 1pg.)
- Order Form for the Official NYS Prescription (PDF, 47KB, 1pg.)
- Pharmacy Request for Follow-up Prescription (PDF, 21KB, 1pg.)
- Register and Order Official Prescriptions Free of Charge
- Q & A for Practitioners
- Lost or Stolen Prescriptions
Narcotic Enforcement
- Loss of Controlled Substances Report (PDF, 80KB, 2pg.)
- License Application to Engage in Controlled Substance Activity (PDF, 84KB, 2pg.)
- Request for Approval to Conduct a Medication Collection Event -- Controlled Substances (PDF, 25KB, 1pg.)
- On-Site Destruction Requests
- Instructions for On-Site Destruction of Controlled Substances (PDF, 65KB, 1pg.)
- On-Site Destruction of Controlled Substances Form (DOH-2340) (PDF, 54KB, 1pg.)
- Controlled Substances Inventory Form (DOH-166) (PDF, 78KB, 1pg.)
- Practitioner Update - Summer 2007 - Internet Prescribing of Controlled Substances (PDF, 185KB, 1pg.)
- Controlled Substances Semi-Annual Report for EMS Agencies
- Application for ALS Agency to Engage in Controlled Substances Activity for Pre-Hospital Care
- Quarterly Controlled Substances Inventory Form for Humane Societies (PDF, 34KB, 1pg.)
- Application for Certification as Euthanasia Technician for Animals (PDF, 23KB, 1pg.)
- Statement of Employer for Euthanasia Technicians (PDF, 15KB, 1pg.)
- Application or Renewal of an Incorporated Society or Municipal Animal Control Facility (PDF, 21KB, 1pg.)
- Methadone Usage Summary Report (PDF, 20KB, 1pg.)
- Certificate of Need to Possess Hypodermic Syringes and Needles (PDF, 11KB, 2pg.)
- Application for Registration for Expanded Syringe Access Demonstration Program (ESAP)" (PDF, 40KB, 2pg.)
These forms are also available by sending a request to:
Bureau of Narcotic Enforcement433 River Street
Suite 303
Troy, NY 12180
Phone: (866) 811-7957
E-mail: narcotic@health.state.ny.us