Common 222 Form errors corresponding to numbers in the sample form below.
Use the correct sample below as a guide for filling out your form.
- Supplier Name, Street Address, City, State, or Zip Code not correct. Complete Supplier name as in example.
- The Name and Title field is incomplete.
- Form not signed.
- Form date not entered.
- Number of Packages not indicated. Complete as in example.
- Size of Package not indicated or extends into the item description field. Complete as in example.
- Incomplete Item Description; name/strength/form. Complete as in example.
- Last Line Completed not correct. Last Line indicates the last order line used on the form, as in the example. Roman numerals are not acceptable.
- Any alteration, erasure, overstrike, trace-over or change on the form will render the form unusable.
- Review the back of the form for official DEA guidelines.