Useful Items

Templates, tools, and guides to operationalize your diversion prevention program.

Incident Reporting & Investigation Templates
Controlled Substance Discrepancy Report

Template for documenting discrepancies from ADC counts, perpetual inventory, and shift counts including root cause classification.

DOCX Template
Diversion Investigation Workflow

Step-by-step investigation flowchart from initial discrepancy through root cause analysis, corrective action, and regulatory reporting.

PDF Process
DEA Form 106 Preparation Checklist

Pre-submission checklist for Theft/Loss of Controlled Substances reports including required documentation and timeline requirements.

Checklist DEA
Monitoring & Surveillance Tools
Practitioner Waste Rate Dashboard

Power BI / Tableau template for tracking controlled substance waste rates by practitioner, unit, and shift to identify outliers.

PBIX Dashboard
ADC Discrepancy Log (Excel)

Track and trend automated dispensing cabinet discrepancies by location, medication, shift, and staff member with auto-flagging.

XLSX Tracking
Behavioral Observation Guide

Signs and indicators of possible impairment or diversion behavior for managers and supervisors in patient-care areas.

Guide Training
Program Documentation Templates
Diversion Prevention Policy Template

Comprehensive policy template covering program scope, roles, surveillance, investigation procedures, and reporting requirements.

DOCX Policy
Annual Program Review Worksheet

Structured self-assessment for annual diversion program effectiveness review including metrics, findings, and improvement plan.

DOCX Review
Committee Charter Template

Diversion prevention committee charter with membership requirements, meeting frequency, reporting structure, and authority.

DOCX Governance
DEA Inspection Readiness
DEA Binder — Site Inspection Checklist

Complete inventory of everything DEA investigators expect to see during a site inspection: registrations, inventories, 222 forms, waste records, training, policies, and audit trails.

Checklist DEA
Training Materials
New Hire Diversion Awareness Training

Slide deck covering controlled substance handling basics, red flags, reporting obligations, and organizational expectations.

PPTX Onboarding
Red Flag Recognition Pocket Card

Quick-reference card for staff identifying common diversion red flags in dispensing, administration, waste, and behavior.

PDF Reference
Peer Support & Recovery Resource Guide

Program information for state-level practitioner health programs, peer assistance, and substance use disorder resources.

Guide Wellness