Forms

Controlled Substances Registration Forms: The Application for Registration and Certificate fo Exemption From Fee must be submitted by mail to the address noted on the forms. Please note that the Application for Registration may be submitted for both new applications and renewals. If this will be a renewal, please mark the form as such and make note of the current CSR Number. 

• Application for Registration (PDF)
• Certificate of Exemption From Fee (PDF)

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 e-mailed to RSD_Customer_Relations@txdps.state.tx.us or faxed to (512) 424-5799.

• Modification of Registration - Practitioners (PDF)
• Modification of Registration - Physician Assistants and Advance Practice Nurses (PDF)
• Modification of Registration - EMS (PDF)
• Report of Theft, Loss, or Surrender of Controlled Substances (PDF)

Precursor Chemical/Laboratory Apparatus Forms: There are several forms available on the DPS web site regarding the Precursor Chemical Statute, including:

• Report of Theft, Loss, or Suspicious Order of Precursor Chemical/Laboratory Apparatus (PDF)
• Precursor Chemical/Laboratory Apparatus One-Time Permit Application (PDF)
• Precursor Chemical/Laboratory Apparatus Business Permit Application (PDF)

Texas Prescription Program Forms: There are several forms available on the DPS web site regarding the Texas Prescription Program, including:

• Doctor/Patient Request of Information (PDF)
• Request for Prescription Transmittal Forms (PDF)
• Prescription Information Transmittal Form (PDF)

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.