Get the free DEA Form 486 - DEA Diversion Control Division

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MANUFACTURER/EXPORTER INFORMATION FORM I. INFORMATION ABOUT THE EXPORTER Title Address Telephone Fax Email; Web Tax Authority of which exporter registered Title Address Telephone Fax Email; Web Registration

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How to fill out dea form 486

01

Obtain DEA Form 486 from the Drug Enforcement Administration website or your healthcare provider.

02

Fill out the patient information section, including name, address, and date of birth.

03

Provide information about the prescriber and pharmacy where the prescription will be filled.

04

Include details about the controlled substance being prescribed, including the name, strength, and quantity.

05

Sign and date the form to certify the information provided.

06

Keep a copy of the completed form for your records and submit the original to the appropriate parties.

Who needs dea form 486?

01

Healthcare providers prescribing controlled substances

02

Pharmacies dispensing controlled substances

03

Patients receiving prescriptions for controlled substances

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What is dea form 486?

DEA Form 486 is the form required by the Drug Enforcement Administration (DEA) for reporting and tracking controlled substances being transferred or disposed of.

Who is required to file dea form 486?

Any entity registered with the DEA that transfers or disposes of controlled substances is required to file DEA Form 486.

How to fill out dea form 486?

DEA Form 486 must be filled out with details of the controlled substance being transferred or disposed of, along with information about the receiving party.

What is the purpose of dea form 486?

The purpose of DEA Form 486 is to track the transfer and disposal of controlled substances to prevent misuse or diversion.

What information must be reported on dea form 486?

Information such as the name of the controlled substance, quantity transferred or disposed of, recipient's information, and the reason for the transfer or disposal must be reported on DEA Form 486.

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