Narcotic Ordering Guidelines

Before your agency can order any narcotics, Federal Law requires that EMP must have on file the following before your agency can purchase narcotics:

1. A completed EMP Prescription Drug Authorization Form, signed by your Medical Director. This form can be downloaded from our website for your convenience.

EMP Prescription Drug Authorization Form

2. A copy of your Medical Director's DEA Certificate. Please note that we can only accept this DEA Certificate, State controlled substance license are NOT acceptable. The ONLY address we can ship your narcotic order to is the address listed on the supplied DEA Certificate. Sorry, NO exceptions. For your convenience, we have implemented an electronic on-line verification service to our system that can be used for verification in lieu of receiving a hard copy of the DEA Certificate. Please ask any of our customer service representatives for details.

Medical Director's DEA Certificate

Please note:The EMP Prescription Drug Authorization Form and the DEA Certification CAN be faxed to us at 800-558-1551.

Please note: After we have received the above information your agencies account is set up in our system allowing your agency to order Class IV Narcotics over the phone, fax or website! After verification, your order is shipped to you immediately.

To place an order for Morphine or any other Class-II Narcotics you MUST send us a completed DEA Form 222 signed by your Medical Director everytime your agency places an order for Class-II Narcotics. Class-II Narcotics are listed online only for informational purposes only. Class-II Narcotics can't be ordered online. For assistance in filling out this DEA provided form, please refer to the numbered instructions below that correspond to the form's picture.

DEA Form 222

1.) Name of Supplier: Emergency Medical Products
2.) Street Address:1711 Paramount Court
3.) City and State: Waukesha, WI
4.) Date: Date form completed
5.) No. of Packages: Quantity of Boxes you would like to order
6.) Size of Package: Number of Units in a Box
7.) Name of the item: Drug name with dose and delivery device (i.e. Carpuject, Vial, Amp)
8.) Last Line Completed
9.) Signature of Purchaser: Medical Director's Signature

Emergency Medical Products (the supplier) will complete the Suppliers DEA Registration, NDC and shipping information for you. This Federal Form 222 is in triplicate: EMP can only accept forms where copies 1 and 2 are unseparated with the carbons intact. Please retain copy 3 for your records. Mail, UPS or FedEx your completed forms with a Purchase Order or a completed EMP Order Form to our address listed below:

Emergency Medical Products, Inc.
1711 Paramount CourtWaukesha,
WI 53186

Thank you for your business!