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Forms

• Applying for an Exemption? (PDF)
• Authorized Users Signature Log (PDF)
• Controlled Substances Registration Form (PDF)
  All U of M departments wishing to conduct research with controlled substances are required to register with the Department of Environmental Health and Safety. Follow this link for further instructions. (Microsoft Word).
• Controlled Substance Disposal Form (PDF)
• DEA Form 225 Instructions (PDF)
• DEA Form 41 (PDF)
  Use to report accidental breakage.
• DEA Registration Instruction Sheet (PDF)
• Large Animal Controlled Substances Form (PDF)
• MNBP Registration Instruction Sheet (PDF)
• Mid-Level Practitioners Addendum (PDF)
• Power of Attorney Transfer Form (HTML)
  Power of attorney may only be granted to another unit registrant according to U of M policy. Please record the Form 222 identifier numbers on the forms transferred on your Form 222 log.
• Minnesota Board of Pharmacy Applications for Researchers (PDF)
• Report of Theft or Loss of Controlled Substances (PDF)
• Research Controlled Substance Inventory (PDF)
• Research Controlled Substance Disposition Record (PDF)
• Security Control Questionnaire(HTML)
• Small Animal Use Record (Single Drug) (PDF)
• Small Animal Use Record (Combination Drug) (PDF)

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