Forms and Manuals


Please Note: All forms are in Portable Document Format (PDF). You will need Adobe Acrobat Reader to view and print.

Prescriber:
Dispenser:

Dispenser Reporting Exemptions: Connecticut does not require a formal written request and approval for accessing dispensing waivers. All dispensing practitioners requiring the use of reporting waivers should read the following PMP dispensing waiver reporting process requirements information page. To report, all practitioners who dispense controlled substances and other reportable drugs and medical devices must register with the PMP CLEARINGHOUSE to upload prescription dispensation data. The PMP requires all practitioners that are authorized to dispense prescription drugs in Connecticut to register with the PMP CLEARINGHOUSE by following the steps at https://portal.ct.gov/DCP/Prescription-Monitoring-Program/Pharmacist-Information and create a CT PMP CLEARINGHOUSE data upload account. An account must be created regardless of the actual prescription drug(s) dispensed. The method for completing reporting compliance is accomplished by maintaining a scheduled upload reporting of dispensing activities using the active PMP CLEARINGHOUSE account.

This type of “dispenser reporting waiver” does not pertain to e-Prescribing Exemption Requests for controlled substances and only applies to CPMRS dispensation reporting. Any prescriber seeking an exemption from e-prescribing of controlled substances can find instructions for making the request at: https://portal.ct.gov/DCP/Drug-Control-Division/Drug-Control/EPCS-Information-Page 

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