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picture1_Printable Inventory Form 192549 | Appendix B7


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File: Printable Inventory Form 192549 | Appendix B7
dea biennial controlled substance inventory form example for the use of controlled substances in research a separate initial inventory is required for each registered location do not submit a copy ...

icon picture PDF Filetype PDF | Posted on 05 Feb 2023 | 2 years ago
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                                                                  DEA Biennial Controlled Substance Inventory Form (Example) 
                                                                           For the Use of Controlled Substances in Research 
                           A separate initial inventory is required for each registered location. Do not submit a copy of the biennial inventory to the DEA or IBPE unless requested 
                                                                                                   
          Date: __________________________________                               DEA Registrant (Print Name): _____________________________________________________________  
          DEA Registration Number: ___________________________                   DEA Registrant Address: ________________________________________________________________________ 
                                                                                                                        (As appears on DEA Form 223) 
          Inventory Performed by: ______________________________________                 ________________________________________     
                                                         Print Name                                      Signature 
          Inventory Witness: _____________________________________________               ________________________________________     
                                                         Print Name                                      Signature 
                            Start of day                                                                           End of day 
                                        2                                                                        3                               4,5,6                             7
           Line     Drug  Information          Controlled Substance Name and            Unopened Containers                Opened Containers                       Finished Form  
           No.1    DEA No.  Schedule                 manufacture/Vendor                  Qty.       Container        Qty.    Container       Remaining                       
          1                                                                                             Size                     Size          amount        
          2                                                                                                                                                  
          3                                                                                                                                                  
          4                                                                                                                                                  
          5                                                                                                                                                  
          6                                                                                                                                                  
          7                                                                                                                                                  
          8                                                                                                                                                  
          9                                                                                                                                                  
          10                                                                                                                                                 
          11                                                                                                                                                 
          12                                                                                                                                                 
                   
                   
          (1) Cross out the unused lines. Keep the biennial inventory record at the licensed-registered location. (2) Schedule I and II drugs must be separated from all other drugs or placed on a 
          separate form. (3) Unopened containers of same substance, manufacturer, volume, and concentration can be listed together. (4) List open containers as separate line items. (5) Measure in 
          weight (powder or crystals) or volume (liquids) or number of units (tablets or capsules). (6) For opened containers: If the substance is listed in Schedule I or II, make an exact count or 
          measure of the contents. (7) Finished form refers to the strength and form of the item as commercially prepared. 
                   
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...Dea biennial controlled substance inventory form example for the use of substances in research a separate initial is required each registered location do not submit copy to or ibpe unless requested date registrant print name registration number address as appears on performed by signature witness start day end line drug information and unopened containers opened finished no schedule manufacture vendor qty container remaining size amount cross out unused lines keep record at licensed i ii drugs must be separated from all other placed same manufacturer volume concentration can listed together list open items measure weight powder crystals liquids units tablets capsules if make an exact count contents refers strength item commercially prepared...

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