PTCB - CONTROLLED SUBSTANCES DIVERSION
PREVENTION CERTIFICATE PRIMARY FOCUS
ON DEA REQUIREMENTS
Terms in this set (69)
Original
The CSOS Registration Authority requires a photocopy of a letter granting
___________________________________ for all applicants (excluding the Registrant) requesting a
CSOS Signing certificate.
power of attorney
POA Requirements
NAME
ADDRESS
%
REGISTRATION #
STATEMENT
NAME/SIGNATURE OF AIF & REGISTRANT
2 WITNESS SIGNATURES
DATE POA GRANTED
Brainpower
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POA signature Requirements
AIF & REGISTRANT
POA requires how many witness signatures?
2
3 multiple choice options
DEA Form 224a
Retail Pharmacy, Hospital/Clinic, Practitioner, Teaching Institution, or Mid-Level Practitioner
DEA Form 225a
Manufacturer, Distributor, Researcher, Analytical Laboratory, Importer, Exporter
DEA Form 363a
Narcotic Treatment Programs
DEA Form 510a
, STUVIA
Domestic chemical
first letter of DEA number for mid level practitioner
M
first letter of DEA number for practitioner
A, B, OR F
Second letter of DEA number
The first letter of registrant's last name
for DEA verification, first
add the 1st, 3rd, & 5th numbers
for DEA verification, secondly
add the 2nd, 4th, & 6th number twice
The first two characters of DEA must be
uppercase letters
third step for DEA verification
add the results of the first two calculations
DEA 222 forms are to be kept for
2 years
Who keeps copy 1 of DEA Form 222?
the purchaser
%
_____________________________ must retain the original of each DEA Form 222 that it has filled
The supplier
part 1 of DEA form
Name and Title
Signature of DEA Registrant
Date
Enter name, size, and quantity of controlled substance(s).
Enter last line completed
part 2 of DEA form
Supplier DEA Number
Supplier address
Make a copy of the signed DEA 222 form ______________ submitting your order form.
before
3 multiple choice options
Fill in Part 5 on copy of DEA 222 form once the order is ____________________
received
2 multiple choice options
Power of Attorney (POA)
for DEA 222 forms, the person who signs the DEA application and renewals, or any individual who
has been authorized by a
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