Form 222 Information

Single-Page Form

Requirements for Properly Completed 222 Forms:

DEA requires that your 222 form address be the same as the address on your current DEA Certificate. DO NOT fill out Supplier DEA Number in Part 2, or anything in Part 3. This information will be completed by ACE SOUTHERN after your order has shipped. Any questions? Call us at 1.888.222.3722.

See Sample form as an example

Name of Supplier: ACE SOUTHERN
Street Address: One Southern Court
City and State: West Columbia, SC 29169
Date: Today's Date (the date you are filling out the form)
Number of Packages: The quantity of drug being ordered
Size of Package: The size of the drug being ordered (ie. 20ml, 10x5ml)
Name of Item: The name and description/strength of the drug being ordered (ie. Fentanyl vial, Fentanyl amps, Demerol 50mg/ml)
Last Line Completed: This number should correspond to the Line No. of the last line on which a product was ordered
Signature of Physician or Power of Attorney: Unsigned forms cannot be processed.
Printed name and title of person signing the form.

*If the signature is anyone other than the Registered Physician, we must have a copy of the Power of Attorney on file

Mistake anywhere on the form? You will need to VOID your entire form, keep it on file and start with a new one. Please do not write over mistakes in an attempt to correct. This is considered an alteration. We cannot accept forms with alterations or errors.

Click here to view the single page form

Order 222 Forms

Order Schedule II Online

Now you can conveniently order Schedule II pharmaceuticals online through our e222 system.

Why should you sign up?

The DEA has created the Controlled Substance Ordering System (CSOS) to allow registrants to place orders for Class II narcotics electronically without the use of manual paperwork. Benefits include:

No more 222 forms returned/voided due to errors.
Faster transaction times - Allows for same day shipment.
Reduced amount of paperwork to complete and retain on file.
Respond quicker to backorders and shortages.

Follow these 4 easy steps to gain access

Enroll

Visit deaecom.gov to enroll
Follow the instructions and mail documentation to the DEA

Install

Retrieve and install your new Digital Certificate
You'll receive an Access Code by email and Access Code Password by postal mail
Use these to retrieve and install the digital signature onto your computer; Note - this must be done within 60 days of the date printed on your postal mailed notice

Call

Call a member of the ACE SOUTHERN DEA Compliance Team at 888-222-3722 to be added to our e222 ordering page and receive login instructions

Test

Perform Digital Certificate Test and Email test on the ordering site
If the test was successful, proceed to the Customer area and place your order
If the test was unsuccessful, contact a member of our e222 support team at 254.933.4452 (option 2)

Still have questions?

If you still have questions about the program call one of the following resources:

Federal DEA CSOS Customer Support 877.332.3266
ACE SOUTHERN DEA Compliance Team 888.222.3722
e222 Website Support Team 254.933.4452