• Complete & Upload Required Documents

  • *All fields required unless noted.

    • 1. DEA Registration Information 
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    • DEA Registration Address

    • Registered State Licenses & Registrations:
      (DVM, DEA, HCCE, etc.) *

      Upload all relevant state-level licenses, including DVM, DEA Registration, and/or clinic licenses (e.g., HCCE). Each license must be valid and match the business address.

    • 2. Business Information  
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    • 3. Controlled Substance Protocol 
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    • 4. Signatures 
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    • 5. Upload Photos 
    • Please note:

      • If you are only changing the veterinarian of record, you do not need to submit new facility photos.

      • If you have moved to a new facility or your security measures have changed, you must submit new photos.

      • Photos below must be submitted before your due-diligence form is approved unless you have previously submitted them.
    • Photo Documentation Quick Guide

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    • The Code of Federal Regulations, 21CFR Part 1301.74(b) requires distributors of controlled substances to design and operate a system to identify suspicious orders. Suspicious orders may include those of unusual size, deviating substantially from a normal historical pattern, and/or orders of unusual frequency.

    • Out of accordion elements: 
    • Should be Empty: