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Controlled Substances
Notification of Controlled Substances Registration
Notification of Controlled Substances Registration
Please complete and submit this form to EH&S when registering or renewing your NC state and DEA controlled substances registration. This form is for EH&S notification only and is not part of the registration process with the state and federal administrations.
Step 1 of 3
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Contact information
Application Type
*
New Application
Renewal
Name
*
First
Last
Date
Date Format: MM slash DD slash YYYY
Email
*
Phone
Location Information
PI Name
*
First
Last
Department
*
Building
*
Room(s) Controlled substances storage area
*
Enter one room number per space, select the "+" button to add additional rooms
Room(s) Controlled substances use area
*
Enter one room number per space. Enter one room number per space, select the "+" button to add additional rooms
Registration Information
Registration Category
*
Individual
Departmental
Registration Type
*
Research
Dispensing / Instructing*
Chemical Analysis
Import / Export
* Includes practitioner, pharmacy, and teaching activities
Schedules Used
*
To select more than one Schedule, hold the "CTRL" key while making your selections...
I
II
III
IV
V
Total Quantity of Each Schedule
*
include units
I
II
III
IV
V
Have you submitted your US DEAL/NC-DCU registration application / renewal yet?
*
Yes
No
I need assistance to complete
Name
This field is for validation purposes and should be left unchanged.
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