Forms

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For Pharmacies

Exemptions and waivers may be allowed in the following instances:

  • Hospital Pharmacies that do not dispense more than a 24-hour supply of a controlled substance to an outpatient. (Inpatient dispensing transactions do not need to be reported.)
  • Pharmacies that dispense controlled substances solely for Institutional Review Board (IRB) approved interventional research trials using investigational drug products that are regulated by the Federal Food and Drug Administration.
  • Pharmacies that are not computerized.
Download Exemption/Waiver Form


Pharmacies without DEA Registrations

If the pharmacy does not have a DEA registration, please complete and return the following form to the Board.

Download DEA Registration Form


No Controlled Substance Prescription Dispensing Activity

If the pharmacy is DEA registered, but does not dispense controlled substance prescriptions to Colorado patients, please complete and return the following form to the Board. The Colorado State Board of Pharmacy will consider such requests in the ordinary course of business and approve or disapprove the request.

Download Controlled Substance Waiver Form

For Research and Education

The Colorado State Board of Pharmacy may provide de-identified data from the Colorado Prescription Drug Monitoring Program to qualified personnel of a public or private entity for the purpose of bona fide research or education, pursuant to a written agreement.

Please complete the following form and checklist and mail the completed copies to the address listed below. Upon receipt of a completed request, the request for an agreement for de-identified data from the Colorado Prescription Drug Monitoring Program will be scheduled for review by the Colorado State Board of Pharmacy at one of its regularly scheduled meetings.

Download ChecklistDownload Request Form

Mail completed copies of the form and checklist to:

Colorado State Board of Pharmacy
Prescription Drug Monitoring Program
1560 Broadway, Suite 1350
Denver, CO 80202


For Law Enforcement

If you require data from the Colorado Prescription Drug Monitoring Program as part of a bona fide investigation, please complete the applicable form and submit it to the Colorado State Board of Pharmacy at contact information listed on the form. Please remember to include the official court order or subpoena.

Download Patient FormDownload Pharmacy FormDownload Prescriber Form

For Third Party or Representation

If you are an individual submitting a request on behalf of another individual who is the recipient of a controlled substance prescription, please complete the following form and remember to include:

Download Third Party Patient Request Form

Pharmacist with laptop examining prescription bottle