Electronic Prescribing Waiver

For a list of prescribers that have been granted a KANSAS waiver for electronic prescribing of opioid controlled substances effective July 1, 2021:
CLICK HERE

Waiver Request Form

INSTRUCTIONS

Form C-700
Prescriber Waiver Request: Electronic Prescribing

STATE OF KANSAS WAIVER ONLY

Please submit the below form to request a waiver for the Kansas electronic prescribing requirements of K.S.A. 65-16,128, effective July 1, 2021. Approved waivers will expire on June 30th and December 31st of each year.

K.S.A. 65-16,128. Electronic transmission of prescription orders required, when; exceptions.
(b)(1) A prescriber may request a waiver from the provisions of subsection (a) for a period not to exceed six months if such prescriber cannot comply with subsection (a) due to economic hardship, technological limitations that reasonably are not within the prescriber's control, or other circumstance demonstrated by the prescriber. If a waiver is granted by the Board of Pharmacy, the prescriber may request that such waiver be renewed for a period not to exceed six months.

PRESCRIBER INFORMATION

REASON FOR REQUEST

Reason for Request (select one)


PRACTICE LOCATION INFORMATION

PRESCRIBER CERTIFICATION

By clicking the "Submit" button below, I certify that I am the prescriber named above and the information contained in this form is true, correct, and complete to the best of my knowledge.

Electronic Prescribing