• Official Prescription Program Order Form

  • • Complete items 1-5. An incomplete form may result in the delay of your order.

    • Do not send this order form in until you have:

    - registered with the NYS Official Prescription Program. Registration can be completed online through the Health Commerce System using the application called ROPES (Registration for Official Prescriptions and E-Prescribing Systems).

    - a current registration certificate, if you maintain one, from the Drug Enforcement Administration. For questions, contact: www.deadiversion.usdoj.gov.

    • Send order form to:

    Taylor Communications

    Official NYS Prescription Program

    P.O. Box 2024

    Toccoa, GA 30577

    • If you have questions about Official Prescriptions, call the New York State Official Prescription Program at 1-866-772-4683.

  • DEA Registered Address: Prescriptions can only be printed and shipped to the address printed on your Drug Enforcement Administration (DEA) Registration. If you do not have a DEA registration, prescriptions can only be printed and shipped to your Primary Practice address registered with the NYS Official Prescription Program.

  • Format: (000) 000-0000.
  • 3. Number of Books (20 book maximum. Order only up to a one-month supply of Official Prescriptions.)

  • By my signature, I certify that I am registered with the DEA (if applicable) and that a current order of the Commissioner of Health revoking or canceling use of such forms has not been served to me.

  • 5. Date
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  • ***ATTENTION PHYSICIAN ASSISTANT***

    Orders must also contain the name, license number and DEA number (if applicable) of the Supervising M.D. Orders not containing this information will not be processed.

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