Pharmacist Procedures for Requesting Access
The PDMP database is an electronic tool developed to provide Pharmacists with a source of information regarding the controlled substance usage of a patient.
To request access to the PDMP Database a Pharmacist must:
Follow the instructions for completing the Prescriber / Dispenser Database Access Request Form.
Complete the Prescriber / Dispenser Access Request form and Privacy Statement form.
- Create a password and place password in the designated area on the Access Request Form
Passwords must be at least 8 characters in length.
Passwords must not contain dictionary words or a name.
Passwords must contain at least one (1) capital letter, (1) lowercase
letter, and (1) number. Example:
H82bYb – would be acceptable
Bob 123 – would not be acceptable
Rover9 – would not be acceptable
- Print the Prescriber/Dispenser Access Request Form and Privacy Statement Form
- Sign and date both forms
- Have Prescriber/Dispenser Access Request Form notarized
- Make a copy of your current AZ Board License, Pharmacy’s DEA Registration, and Driver’s License
- Retain a copy of all forms 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 Prescriber/Dispenser Access Request Form
(Note: ASBP will not process a faxed Access Request Form)
- Signed copy of the Privacy Statement Form
- Copies of current AZ Board License, Pharmacy’s DEA Registration, and Driver’s License
Arizona State Board of Pharmacy
Controlled Substances Prescription Monitoring Program
1700 W. Washington Street, Suite 250
Phoenix, Arizona 85007-2835
Once the Access Request documents are received and approved, the requestor will receive an e-mail from our 15-minute online training course at careermap.net. Once the requestor has completed the online training course, ASBP's technical expert (Health Information Designs) will notify the requestor via two separate e-mails. The first e-mail will contain a CSPMP system Login User Name and the Database Web Link. The second e-mail will contain a PIN number and an 800 help desk phone number.
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.
