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AAHA Important things to remember when ordering your Schedule 2 and 2N Controlled Drugs Listed below is detailed information to help you in filling out the DEA Form 222 for schedule 2 2N drugs. This form is only to be used in ordering schedule 2 2N drugs. Do you have the correct MWI address on the form and envelope For states WA OR ID CA NV UT AZ 8900 W. Hurley Avenue Ste. This form is only to be used in ordering schedule 2 2N drugs. Do you have the correct MWI address on the form and envelope For states WA OR ID CA NV UT AZ 8900 W. Hurley Avenue Ste. 101 Visalia CA 93291 For states CT DC DE MA MD ME MI NH NJ NY OH PA RI VA VT WV 1499 Zeager Road Suite 2 Elizabethtown PA 17022 For all other states 2450 Midpoint Drive Edwardsville KS 66111 SAVE THIS WITH YOUR 222 ORDER FORMS FOR FUTURE REFERENCE Is your address correct Product will be shipped to the address on the DEA license ONLY. Did you look at the back of the blue copy Be sure to refer to the back of the blue copy of your 222 form for complete instructions. Supplier s Address MWI s address SEE ADDRESS ABOVE MWI Veterinary Supply Mo-Day-Year Blank Btl/100 Codeine 15mg tabs 250cc Fatal Plus sodium 6 grain/mL 100cc Sleepaway 260mg/mL 2mg/mL Leave blank Last Line Completed Enter only the number of the lines used. In the example above the last line completed would be 4. 101 Visalia CA 93291 For states CT DC DE MA MD ME MI NH NJ NY OH PA RI VA VT WV 1499 Zeager Road Suite 2 Elizabethtown PA 17022 For all other states 2450 Midpoint Drive Edwardsville KS 66111 SAVE THIS WITH YOUR 222 ORDER FORMS FOR FUTURE REFERENCE Is your address correct Product will be shipped to the address on the DEA license ONLY. Do you have corrections on the form Form 222 can contain NO corrections or strike-over marks. Did you sign your form This form is invalid without a proper signature. Must be signed by the DEA registrant or a person authorized by a power of attorney. MWI must have a copy of this power of attorney at one of our approved locations to process the order. Supplier s Address MWI s address SEE ADDRESS ABOVE MWI Veterinary Supply Mo-Day-Year Blank Btl/100 Codeine 15mg tabs 250cc Fatal Plus sodium 6 grain/mL 100cc Sleepaway 260mg/mL 2mg/mL Leave blank Last Line Completed Enter only the number of the lines used. In the example above the last line completed would be 4. Signature 2 2N 3 3N 4 5 Practitioner mple sa 123456789 Doe E. John DVM ABC Veterinary Clinic 1234 Main Street Anywhere USA 123445 Signature Must be signed by the DEA registrant or a person authorized by a power of a copy of this power of attorney at one of our approved locations to process the order. AAHA Important things to remember when ordering your Schedule 2 and 2N Controlled Drugs Listed below is detailed information to help you in filling out the DEA Form 222 for schedule 2 2N drugs. 101 Visalia CA 93291 For states CT DC DE MA MD ME MI NH NJ NY OH PA RI VA VT WV 1499 Zeager Road Suite 2 Elizabethtown PA 17022 For all other states 2450 Midpoint Drive Edwardsville KS 66111 SAVE THIS WITH YOUR 222 ORDER FORMS FOR FUTURE REFERENCE Is your address correct Product will be shipped to the address on the DEA license ONLY.

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