K-TRACS Forms

• NEW Data Requester Certification Form - Must be completed and uploaded with your online registration.

•  Data Requester Notary Form - Must be completed and uploaded with your online registration.

• Patient Request Form - PLEASE NOTE:  An appointment is required at the K-TRACS office to pick up your report.  Appointments can be made by calling 785-296-4056.

• Third Party Release Form - Use this form to allow PMP report to be released to a third party.

Prescriber History Request Form

• Prescriber Request Form - Use this form to request your own controlled substance prescribing history report.

• Extension Request Form (if you will be delayed in reporting)
• Electronic Reporting Waiver Form (if you cannot report electronically - paper still required)
• Exemption From Reporting Form (if you believe you should not have to report)

Registered K-TRACS Users - Account Update/Changes Form

• Update K-TRACS Account Information Form