Iowa Administrative Code
Agency 657 - PHARMACY BOARD
Chapter 12 - PRECURSOR SUBSTANCES
Rule 657-12.3 - Form of reports
Universal Citation: IA Admin Code 657-12.3
Current through Register Vol. 46, No. 19, March 20, 2024
All reports shall be on forms provided by the board except as provided in rule 12.4(124B). The following minimum information shall be completed for each required report.
(1) Delivery. Each form that reports the sale, transfer, or other furnishing of a precursor substance shall contain the following information:
a. Name of
substance;
b. Quantity of
substance;
c. Date sold,
transferred, or furnished;
d. Name
and address of business or person selling, transferring, or furnishing the
substance;
e. The signature of the
person or the signature of an officer, authorized agent, or authorized employee
of the business selling, transferring, or furnishing the substance;
f. Name, address, and identification
information of the person or business purchasing or receiving the
substance.
(2) Receipt. Each form that reports the receipt of a precursor substance shall contain the following information:
a. Name of substance;
b. Quantity of substance;
c. Date received;
d. Name and address of person or business
receiving the substance;
e. The
signature of the person or the signature of an officer, authorized agent, or
authorized employee of a business receiving the substance;
f. Name and address of the person or business
selling, transferring, or furnishing the substance.
(3) Theft or loss. Each form that reports a missing quantity of a precursor substance shall contain the following information:
a. Name of missing
substance;
b. Quantity of substance
missing;
c. Date on which the
substance was discovered to be missing;
d. Name and address of the person or business
reporting the missing quantity;
e.
The permit number of the person or business reporting the missing quantity, if
applicable;
f. The signature of the
person or an officer, authorized agent, or authorized employee of the business
reporting the missing quantity;
g.
The name and address of the person who transported the precursor substance and
the date of shipment, if applicable.
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