LAR Controlled Drug Request Form

To request controlled substances, please submit the following information. Please allow 72 hours for the order to be filled. If you have any questions, please contact the LAR Veterinarians.

Today's Date*

MonthDayYear

Date Needed By*

MonthDayYear

Today's Date*

MonthDayYear

Requestor (the person who will pick up the controlled drugs)*

First NameLast Name

Requestor E-mail*

Lab's Phone number*

PI*

Account #*

ACUP #*

Storage Location*

Please include building and room number

Drug Name*

How many vials of drug?*

Dr. Travis Hagedorn
Office Tel: 913-588-7093
Email: thagedorn@kumc.edu
Cell: 913-530-2416

Dr. Allison Bright
Office Tel: 913-945-7038
Email: abright3@kumc.edu
Cell: 703-615-9455