Resources

PDMP Forms

For Pharmacies and Other Dispensers:

• Application to Change a Dispenser's Data Submission Status

  For dispensers who hold a Wisconsin license and do not dispense monitored prescription drugs such as controlled substances in Schedule II-V or gabapentin.

• Application for an Emergency Temporary Waiver of the Next Business Day Submission Requirement

  For dispensers who are unable to submit data during a reporting period.

For Others:

• Report of Suspected Errors in WI ePDMP Data

  For healthcare professionals and other PDMP data users to report a suspected error with the data available from the Wisconsin ePDMP.

• Patient PDMP Data Request Form

  For the patient or a person authorized by the patient to request the monitored prescription drug history report about the patient.