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Controlled Substances Registration Forms

Effective July 1, 2016, DPS waives the $25.00 new/original application fee. New applications will be accepted and processed until September 1, 2016. Submit all new/original applications electronically via the contact us link.

Instructions for submitting new applications can be found at CSR Licensing & Registration.

CSR’s may be verified by visiting the CSR Search & Verification System.   New certificates will be issued.

New applications and/or fees received and processed prior to July 1, 2016 will not be returned or refunded. Applications and/or fees received after July 1, 2016; applications will be processed; checks will be returned to the applicants.

Physician Assistant/Advanced Practice Nurse

Prior to registration or renewal your supervising/delegating physician must be listed with the Texas Medical Board as giving you prescriptive authority for controlled substances.  The information must reflect an approval date and “yes” must be indicated for controlled substances as well as delegating prescriptive authority. 

Emergency Medical Services (EMS)

EMS may use the Application for Registration/Renewal for Practitioners with additional information.  Signature of the EMS administrator, as listed with Texas DSHS, may sign in the space for “Signature of Applicant.”  The Medical Director’s signature, CSR number and Board license number are required.  This can be added at the bottom of the form.

The Modification of Registration - EMS form may be used to include the current information for the DSHS listed Administrator and Medical Director as recorded on the DSHS website.

Pharmacy

Pharmacies will use the same application as practitioners.  The fields for name, DOB and SSN may be left blank.  Indicate the name of the Pharmacy in the address information area.

The Modification of Registration and Report of Theft, Loss or Surrender of Controlled Substances forms listed below must be signed by the registrant. The completed form may be scanned and emailed via send a secured email or faxed to (512) 424-5799.

Precursor Chemical / Laboratory Apparatus Forms

Texas Prescription Program Forms

Multi-County Drug Task Force Application (NAR-122) 
This form is for use by law enforcement agencies seeking to create a new multi-county drug task force.