The New Jersey Dangerous Substance Registration form is a crucial document for professionals and entities dealing with controlled dangerous substances within the state. It mandates the registration with the New Jersey Office of the Attorney General, Division of Consumer Affairs, Drug Control Unit, ensuring lawful manufacture, prescription, distribution, dispensation, or research of these substances. Registration is only applicable for locations within New Jersey and requires a fee, with processing times ranging from 4-6 weeks.
In New Jersey, individuals and entities handling controlled dangerous substances (CDS) are required to navigate a regulatory landscape that ensures these substances are managed safely and legally. Central to these regulations is the New Jersey Dangerous Substance Registration form, a critical document overseen by the Office of the Attorney General Division of Consumer Affairs Drug Control Unit. This form is a prerequisite for anyone involved in the manufacture, prescription, distribution, dispensation, research, or analysis of controlled dangerous substances within the state. Notably, this requirement extends to a wide range of professionals including, but not limited to, medical doctors, dentists, veterinarians, optometrists, and pharmacies, each of whom must hold both state and federal registrations to legally operate with these substances. The application process is accompanied by a fee and a standardized set of information must be provided, reflecting the dual concerns of legal compliance and public safety. Additionally, if an applicant has moved or intends to move their practice to New Jersey, specific procedures involving the Drug Enforcement Administration must be followed to ensure that DEA registrations are properly transferred or obtained. This complex process underscores the significant responsibilities placed on professionals working with dangerous substances and highlights the rigorous controls in place to prevent misuse, ensuring that New Jersey’s strict standards for public health and safety are upheld.
New Jersey Ofice of the Attorney General
Division of Consumer Affairs
Drug Control Unit
124 Halsey Street, 3rd Floor, P.O. Box 45045, Newark, NJ 07101
(973) 504-6351
Controlled Dangerous Substance Registration
Instruction sheet
Enclosed is a Controlled Dangerous Substance (C.D.S.) application, which you are required to submit pursuant to N.J.S.A. 24:21-1 et seq. Registration is required for every person who, or irm that, manufactures, prescribes, distributes, dispenses or conducts research or
analysis utilizing controlled dangerous substances.
A New Jersey C.D.S. registration is issued only for a New Jersey location. Be sure to include a $20.00 check or money order,
payable to “State of New Jersey.” It will take 4-6 weeks to process this application. Your C.D.S. registration will be mailed to the mailing address on ile with your professional licensing board.
Please note:
1.If you have a current D.E.A. number in another state and plan to discontinue practice in that state, you may transfer that D.E.A. number to New Jersey by providing the following to the Drug Enforcement Administration, 80 Mulberry Street, Newark, New Jersey 07102, (888-356-1071) www.deadiversion.usdoj.gov:
a.a copy of your New Jersey professional license or a veriication letter from the licensing board;
b.a copy of your New Jersey C.D.S. registration or a veriication letter;
c.a copy of your out-of-state D.E.A. registration; and
d.a letter requesting an address change to the same address that is on your New Jersey C.D.S. registration.
A D.E.A. number is only valid in the state listed on the certiicate.
2.If you plan to practice in both New Jersey and the state(s) where you currently hold a D.E.A. registration(s), you must also obtain a D.E.A. registration for New Jersey. Please contact the D.E.A. at the address indicated above and complete the New Jersey application.
3.In order to complete the attached application, please note:
a.A dispenser/prescriber/ practitioner includes medical doctors, doctors of osteopathy, dentists, optometrists, veterinarians, and podiatrists. A mid-level dispenser/prescriber/practitioner includes physician assistants, advanced practice nurses and certiied nurse midwives. Pharmacies must complete a separate application.
b.Every person or irm handling controlled dangerous substances in New Jersey is required to have both a state and federal registration for that purpose. Federal facilities do not require registration.
c.The address supplied must be current and an actual location where controlled dangerous substances will be stored, prescribed, dispensed, etc. The address cannot be solely a post ofice box.
d.Dentists and optometrists may only register at the address for which they hold a current registration issued by their board and at which the C.D.S. registration is required pursuant to 3(c) above.
e.Individual practitioner applicants (medical doctors, dentists, veterinarians, etc.) must use their own name, not professional association/corporation or partnership information.
f.Pharmacies are required to use their common trading name (e.g. David Pharmacy), not a business or corporate name.
g.Dispensers/Prescribers must have an active and current New Jersey professional license number. Please write in your New
Jersey professional license number in “Section B” of the application.
•Advanced Practice Nurses may prescribe controlled dangerous substances, but may not purchase or maintain any stock supplies of any C.D.S. medication.
•Optometrists are authorized to prescribe/dispense only Schedule III, IV and V controlled substances and must have an O.M. number registered with their board.
4.If more space is required for your response to any question on the application, please submit a separate sheet of paper identifying the section(s) to which you are responding.
If we can be of further assistance, please call 973-504-6351.
6/08
New Jersey Is An Equal Opportunity Employer Printed on Recycled Paper and Recyclable
Initial Application for Registration
for Dispenser – Pharmacy
P.O. Box 45045
New Jersey Controlled Dangerous Substances Act
Newark, NJ 07101
N.J.S.A. 24:21-1 et seq.
Please type or print irmly with a ballpoint pen.
Section A:
All of the items in this section must be completed.
Section B:
Pharmacy Licensure Information
1. Provide the applicant’s name and the place of business to be registered (do
not use solely a P.O. box). registration will be provided for New Jersey
Pharmacy permit number _____________________________________
locations only. If the registration is for a University of Medicine and
Dentistry of New Jersey facility, include the department, room number,
designation, e.g. MEB, MSB, etc. The address of record must be your
Section C:
Business Information
practice location.
1. List the name, address and telephone number of the person who has
________________________________________________________
administrative or managerial responsibility for the registered location.
Pharmacy trade name
Last name
First name
MI
C.D.S. – Responsible Individual
Department
Room number
2. List the name, address and telephone number of the registered agent (if
a corporation) or the name and address of the New Jersey resident upon
Street address
whom process may be served (if a nonresident proprietor or partner).
________________________
New Jersey
__________________
City
ZIP code
____________________________ __________________________
Home telephone number (include area code)
Business telephone number (include area code)
Note: Please note that the above-registered address is subject to inspection pursuant to N.J.S.A. 24:21-31 & 32.
2. Registration requested as: Dispenser ($20)
Make the check or money order payable to: State of New Jersey
Section D:
Certiication
3. Registration requested in the following Schedule(s):
Schedule
II
III
IV
V
I, ______________________________________ being duly sworn,
4. (a) Has any restriction been imposed which would affect your privilege
depose and say under penalty of false statement, that I am the person
to hold a controlled dangerous substances (C.D.S.) registration for
Schedule II, III, IV or V substances in New Jersey, any other state,
described and identiied in this application; that the information given
the District of Columbia or in any other jurisdiction?*
in this application and all submitted materials contain no willful
Yes
No
misrepresentations and that the information is true and complete. I
(b) Have you been arrested, indicted or convicted of a crime in
understand that should an investigation at any time disclose otherwise,
connection with controlled substances under federal law or the laws
my application may be rejected, and I may face legal sanctions if I
of New Jersey, any other state, the District of Columbia or any other
am already registered. I understand that in signing this application for
jurisdiction?*
registration, I am consenting to any reasonable inquiry that may be
(c) Have you ever surrendered a controlled drug registration or had a
necessary to verify the information that I have provided on this form
controlled drug registration revoked, suspended or denied in New
or may provide in conjunction with this application.
Jersey, any other state, the District of Columbia or in any other
(d) If the applicant is a corporation, association, or partnership: has any
oficer, partner, stockholder holding 10% or more of the outstanding shares
______________________________________
or employee who has access to controlled dangerous substances been
Applicant's full signature
convicted of a crime in connection with controlled substances under
federal law or the laws of New Jersey, any other state, the District of
Columbia or any other jurisdiction?*
(e) If the applicant is a corporation, association, or partnership: has any
oficer, partner, stockholder holding 10% or more of the outstanding
Date
shares or employee who has access to controlled dangerous substances
surrendered a controlled drug registration, had a controlled drug
registration suspended, revoked, or denied, or owned or worked
for an entity which has surrendered or had revoked, suspended, or
denied a controlled drug registration under federal law or the laws
* If "Yes," attach a letter setting forth the circumstances of such action.
DDC-25
Revised 6/08
FOr StAte USe ONlY
C.D.S. number________________________
Effective date ___________________________ Expiration date ______________________
Retain the last copy for your records. Mail the remaining copies with your fee to the above address.
When applying for the New Jersey Dangerous Substances Registration, it's essential to accurately and thoroughly complete your application to ensure compliance with state laws concerning controlled substances. This form is a critical step for professionals and entities that manufacture, prescribe, distribute, dispense, or conduct research with controlled substances in New Jersey, requiring a state-specific registration in addition to any Federal registration you may have. Preparing in advance and following each step carefully can streamline the process, avoiding delays in your application. Let's walk through each step to correctly complete and submit your application.
Completing the New Jersey Dangerous Substance Registration form accurately and submitting it with the correct fee is the first step in ensuring you're compliant with state regulations. Once submitted, expect the process to take 4-6 weeks, after which your registration will be mailed to the address filed with your professional licensing board. This registration is a legal requirement for anyone handling controlled substances in New Jersey, fostering a safe and regulated environment for their use and distribution.
The Controlled Dangerous Substance (C.D.S.) registration is a requirement set by the New Jersey Office of the Attorney General, Division of Consumer Affairs, Drug Control Unit for individuals or firms engaged in manufacturing, prescribing, distributing, dispensing, researching, or analyzing controlled substances. This includes medical doctors, dentists, veterinaries, optometrists, podiatrists, physician assistants, advanced practice nurses, certified nurse midwives, and pharmacies. The registration ensures that these professionals or entities are authorized to handle controlled dangerous substances within New Jersey.
To apply for a New Jersey C.D.S. registration, complete the attached application form, ensuring all sections are accurately filled out. Include a $20.00 check or money order made payable to "State of New Jersey" with your application. Submit this package to the address provided on the instruction sheet. Processing the application typically takes 4-6 weeks. It's important to note that the application must be filled out using a ballpoint pen or typed for clarity.
Yes, if you have an active D.E.A. number in another state and plan to discontinue your practice there, you can transfer your D.E.A. number to New Jersey. To do so, provide the Drug Enforcement Administration with a copy of your New Jersey professional license or verification letter, a copy of your New Jersey C.D.S. registration or a verification letter, a copy of your out-of-state D.E.A. registration, and a letter requesting an address change to match the address on your New Jersey C.D.S. registration.
Yes, pharmacies must complete a separate application from individuals like dispensers or prescribers. It is required that pharmacies use their common trading name, as opposed to a business or corporate name, when applying.
The fee for the C.D.S. registration application is $20.00. This fee is payable by check or money order to the "State of New Jersey." It is crucial to include this payment with your application to avoid delays in processing.
On the application, you will be requested to select the schedules of controlled substances you intend to handle — Schedule II, III, IV, or V. It is important to understand the classifications of these schedules to accurately complete your registration based on the substances you will work with. This selection considers the medical use, potential for abuse, and acceptability for medical treatment in the United States of the substances.
If you have been arrested, indicted, or convicted of a crime connected to controlled substances under any jurisdiction, or if you have ever surrendered a controlled drug registration or had one revoked, suspended, or denied, you must disclose this information on your application. It's required to attach a letter detailing the circumstances of such actions for clarity and further review during the application process.
After submitting your application along with the required fee and any other requested documentation, the Drug Control Unit will process your request, which may take 4-6 weeks. Upon approval, your C.D.S. registration will be mailed to the address you provided, associated with your professional licensing board. Keep in mind that the application and the facility may be subject to inspection to ensure compliance with New Jersey laws and regulations regarding controlled dangerous substances.
Applying for registration involving controlled dangerous substances in New Jersey requires meticulous attention to detail. Applicants often overlook critical steps when completing the New Jersey Dangerous Substance Registration form, leading to delays and potential legal complications. Below, we elucidate common missteps made during the application process:
Using Incorrect Personal Information: Individuals frequently use professional, corporate, or partnership names instead of their legal names. It’s imperative for medical doctors, dentists, veterinarians, and other individual practitioners to use their own name, as specifically mandated by the instructions.
Failing to Provide the Correct Address: A valid New Jersey location for the storage, prescription, dispensation, or use of controlled dangerous substances must be provided. The use of solely a post office box is not acceptable. Additionally, certain professionals such as dentists and optometrists are restricted to register only at addresses where they hold a current registration.
Overlooking the Requirement for Both State and Federal Registrations: Every person or firm that handles controlled dangerous substances in New Jersey is required to hold both state and federal registrations, not accounting for federal facilities. Applicants sometimes mistakenly think one suffices, leading to non-compliance with state regulations.
Not Including Payment: The application process requires the inclusion of a $20.00 check or money order payable to “State of New Jersey.” This detail can be easily overlooked, leading to processing delays.
Insufficient Detail in Application: When more space is required for a response, applicants must attach a separate sheet of paper identifying the sections to which they are responding. Failing to do so can result in an incomplete application, and thus, processing delays.
These missteps not only prolong the process but can carry significant legal implications if not addressed promptly. Ensuring accuracy, completeness, and adherence to the specific requirements of the New Jersey Dangerous Substance Registration form is crucial for a smooth registration process.
When handling the registration process for controlled dangerous substances in New Jersey, it is vital to understand that the New Jersey Dangerous Substance Registration form is just one part of a broader spectrum of documentation needed to ensure compliance with both state and federal regulations. Here are several documents and forms often required alongside the New Jersey Dangerous Substance Registration form, each serving a distinct purpose in the regulatory landscape:
The path to compliance with controlled dangerous substance regulations is multifaceted, requiring attention to detail and an understanding of the various documents necessary to legally prescribe, dispense, or handle these substances in New Jersey. Each form plays a pivotal role in the overarching goal of substance control and abuse prevention, contributing to public health and safety.
The New Jersey Dangerous Substance Registration form bears similarity to the Drug Enforcement Administration (DEA) Registration Application due to its requirement for practitioners, pharmacies, and manufacturers to obtain legal authorization to handle controlled substances. Both forms necessitate detailed information about the applicant's professional credentials, business location, and the specific controlled substances they intend to manage. These parallels ensure that only qualified individuals and entities can distribute or prescribe controlled substances, enhancing the regulatory oversight of drug distribution within federal and state jurisdictions.
Another document similar to the New Jersey Dangerous Substance Registration form is the Pharmacy Permit Application used by state Boards of Pharmacy. This application requires pharmacies to provide comprehensive business information, proof of pharmacist-in-charge credentials, and details regarding their physical premises. Similar to the New Jersey form, its purpose is to vet pharmacies for compliance with state laws governing the storage, dispensing, and record-keeping of pharmaceuticals, including controlled substances, ensuring public safety and drug integrity.
The Controlled Substance Inventory Form, which must be regularly completed by entities handling controlled substances, also shares similarities. This form requires entities to record quantities of controlled drugs on-hand, mirroring the accountability aspect of the New Jersey registration process. Both documents play crucial roles in combating drug diversion by ensuring that all controlled substances are accurately accounted for, thereby preventing misuse and illegal distribution.
Finally, the Healthcare Professional License Application, utilized by various state licensing boards for professions such as medicine, dentistry, and veterinary, parallels the New Jersey Dangerous Substance Registration form. Although primarily focusing on granting the authority to practice a healthcare profession, it often encompasses permissions related to the prescription and management of controlled substances. Applicants must provide detailed personal and professional information, similar to the New Jersey registration, reaffirming their eligibility and adherence to regulatory standards for public health protection.
When completing the New Jersey Dangerous Substance Registration form, there are several do's and don'ts that are crucial for a successful submission. Below you will find a comprehensive list guiding you through the process:
Adhering to these guidelines will streamline the process and help ensure that your registration is processed without unnecessary delays or issues.
There are several misconceptions about the New Jersey Dangerous Substance Registration form that need clarification to ensure proper understanding and compliance. These misconceptions can lead to confusion and potential non-compliance with the state laws governing controlled dangerous substances.
Correcting these misconceptions is crucial for those handling controlled dangerous substances in New Jersey to ensure they comply with all regulatory requirements and avoid potential legal issues. Understanding the actual requirements and processes involved in the New Jersey Dangerous Substance Registration is vital for all practitioners and firms involved in the manufacture, prescription, distribution, dispensation, research, or analysis of controlled dangerous substances within the state.
Filling out and using the New Jersey Dangerous Substance Registration form is a critical process for professionals and businesses dealing with controlled substances within the state. Understanding the key aspects of this process can ensure compliance and facilitate smoother operations. Here are seven key takeaways:
These takeaways underscore the comprehensive nature of New Jersey's approach to the regulation of controlled substances. Compliance with these stipulations ensures the legal and responsible handling of these substances, reflecting the state's commitment to public health and safety.
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