Michigan Department of Community Health
Bureau of Health Professions
MAPS Program
P.O. Box 30202
Lansing, MI 48909
(517) 373-1737
MAPS REQUEST FOR WAIVER FROM ELECTRONIC FILING
By completing and submitting this application you are indicating that you will be dispensing controlled
substances, other than samples, from this location. Only prescriptions dispensed (patient leaving
with medication in container), not administered or prescribed, will need to be reported. This waiver
only applies to the individual who has signed this application. Each licensee in a group
practice must complete his or her own waiver form.
The requirements to submit in paper form are as follows: Cannot submit electronic claims in the
ASAP format; do not have access to connect to the Internet; do not have access to a compatible
personal computer. If you do not have the capability to report this information electronically via the
American Society for Automation in Pharmacy (ASAP) format, or directly using a Windows-based
program provided by GC Services, a waiver may be granted allowing you to submit this information
by paper form. An inspection may be required.
To obtain a MAPS Request for Waiver:
You may print the MAPS Request for Waiver from our website at www.michigan.gov/healthlicense,
under the Spotlight section click on Michigan Automated Prescription System, then scroll to the
bottom of the page to the Information box. You may also request a waiver in writing to the address
above and a form will be mailed to you. If you have questions in regards to the application process,
you can e-mail questions to MAPSINFO@michigan.gov, or call our office during normal business
hours.
Eligibility: MUST have all of the following:
• Professional License
• Controlled Substance License
• Drug Enforcement Administration (DEA) Registration
• Drug Control License (Exempt for samples or veterinarians)
NOTE:
Each time a controlled substance is dispensed, including refills, a MAPS Claim
Form sh