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Forms

Reporting Dispenser Forms

Data Requester Certification Form (For Healthcare Professionals Only)

Data Requester Notary Form (For Other Professionals)

Registered K-TRACS Users - Account Update/Changes Form

Patient Request Form
Please e-mail your request to pmpadmin@ks.gov.

Prescriber History Request Form (For Prescribers Only)
Please e-mail your request to pmpadmin@ks.gov.