REQUIRED: ONE Application For Each Facility Type and ONE Background Check Packet For The Designated Representative. Completed Fingerprint Card (FD-258) MUST Accompany Each Background Check Packet.
Fingerprint cards (FD-258) may be available at your Department of Public Safety or your local law enforcement agency. You may request fingerprint cards by emailing firstname.lastname@example.org. In your email, you MUST provide the number of cards requested and your mailing address.
NEW REQUIRED DOCUMENTATION: YOU ARE NOW REQUIRED TO SUBMIT A DESCRIPTION OF SERVICES PROVIDED BY YOUR FACILITY. THIS INFORMATION SHOULD BE ATTACHED WITH YOUR APPLICATION PACKET.
If you need to make the following changes to an existing Drug Facility Permit, please use the Change Form linked below: Physical Address Change, Business Name Change and/or Designated Representative Change.
NOTE: If you are changing the Designated Representative on an existing Drug Facility Permit, please submit the Change Form including appropriate fees ($500 Amendment to Permit Fee) along with a Drug Facility Permit Background Check Packet for the new Designated Representative, Fingerprint Card for the new DR as well as the $40 Background Check Fee for the new DR.