Patient Procedures for Requesting Access
The PDMP database is an electronic tool developed to provide Practitioners and Pharmacists with a source of information regarding the controlled substance usage of a patient. A patient may access their own controlled substances information.
To request access to the PDMP Database a Patient must:
- Complete the Individual's (Patient) Own Access Request form
- Print the Individual’s Own Access Request Form
- Sign and date the form
- Have Individual’s Own Access Request Form notarized
- Make a copy of your current Driver’s License
- Retain a copy of the form for your records
(Note: If the Access Request Form is filled in by hand, block print must be used to increase legibility.)
Mail the following items to the Controlled Substances Prescription Monitoring Program:
- Notarized Individual’s (Patient) Own Access Request Form
(Note: ASBP will not process a faxed Access Request Form)
- Copy of current Driver’s License or other government-issued identification
Arizona State Board of Pharmacy
Controlled Substances Prescription Monitoring Program
1700 W. Washington Street, Suite 250
Phoenix, Arizona 85007-2835
(602) 771-2744
Report delivery options:
A report can be faxed or mailed or the individual may pick the report up at the Board office. Please indicate on the Access Request Form which method of delivery is desired.
Note: ASBP will not process a faxed Access Request Form. Supporting documents can be sent via fax or e-mail (dwright@azpharmacy.gov) however, CSPMP staff recommends that all documents be sent via mail. If you choose to send your supporting documents via fax or e-mail, please make sure all documents are legible.
