Dear Pharmacists-In-Charge at all NH Pharmacies:

Attached, you will find a new NH Controlled Drug Loss Reporting Form - this form can also be found on the Board’s website at:   
The completed forms can be either mailed, faxed to 271-2856, or emailed to

 In order to ensure consistency in the reporting of all controlled drug losses and allow the Board to properly track them, this is now the only acceptable form for submitting controlled drug losses to the Board – we will no longer accept the old paper DEA 106 forms or any other chain-specific reporting forms.  Please note that this change in no way affects your reporting of controlled substance losses to the Federal Drug Enforcement Administration (DEA), which has its own reporting requirements.  As a reminder of NH controlled drug loss reporting requirements, please see below:  Controlled Drug Losses.

(a)      The pharmacist-in-charge or pharmacist on duty shall report to the board in writing, any theft or significant loss of controlled substances within one business day.  The pharmacist-in-charge shall complete a New Hampshire Drug Loss Form and mail, fax, or email to the board as soon as the investigation into the loss is complete but no later than 30 days of the discovery of the loss.

(b)     All instances of diversion must be reported.

 (c)  A pharmacy shall keep a perpetual inventory for all Schedule II drugs and actual counts shall be verified monthly. The inventory reports shall be maintained for a minimum of 2 years.
(d)  A pharmacy shall consider a controlled drug loss to be significant when:

          (1)  The percentage of dosage units of a specific drug exceeds 2% of monthly dispensing volume; or  

          (2)  Fifteen or more dosage units are not accounted for.

 (e)  The written report referenced in (a) shall contain at least the following:

           (1)  Date of discovery;

           (2)  The identity of the person making the discovery;

           (3)  The name and location of the pharmacy from which the drug is missing;

           (4)  Name, strength, dosage form, NDC and quantity of the missing drug(s); and

           (5)  The cause of the controlled drug loss as determined by the investigation.

 Thank you!

Board of Pharmacy  -  Compliance Department

Division of Health Professions
NH Office of Professional Licensure & Certification

Philbrook Building, 121 South Fruit Street, Suite 401, Concord, NH 03301-2412

Tel: (603) 271-2350  |  Fax: (603) 271-2856  |  Website:

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New Hampshire Pharmacists Association 

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The mission of the New Hampshire Pharmacists Association is to promote, enhance, and advance pharmacy practice, in the State of New Hampshire by advocating for the professional interests of pharmacists, pharmacy technicians, student pharmacists, and ancillary pharmacy personnel as well as to advocate for the health and welfare of the general public.

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