Alabama State Board of Pharmacy

10 Inverness Center, Suite 110

Birmingham, Al 35242


CONSULTANT APPLICATION

 

No fee is required, however, applicant must register initially and annually with the Alabama State Board of Pharmacy. The Board should be notified within ten (10) days after termination of service.

 

Name:*
Email Address:* (yourname@yourisp.com)
License #:*
Address:*
Address (continued):*
City:*
State:*
Name/Address of Facility:*


Are drugs stored and dispensed in compliance with Section 34-23-74, Chapter 23, Code of Alabama 1975?   Yes
*       No *


PHARMACIST CONSULTANTS OF PHARMACEUTICAL SERVICES, RULE 680-X-2-.08, Title 34, Chapter 23, Code of Alabama 1975 reads (in part) as follows:

 

"An increasing number of pharmacists are serving as pharmacy consultants to, or serving as coordinators of pharmaceutical services solely directed in the area of consultation to health care professionals regarding medication/treatment regimens and not to include management consultation, in long term care facilities, assisted living facilities, nursing homes, domiciliaries, homes for the aged, governmental agencies and other places where a pharmacy permit is not held. The Alabama State Board of Pharmacy has the responsibility to maintain standards of professional conduct and to regulate professional practice. Due to the complexity of state and federal regulations pertaining to the provision of pharmaceutical care to the residents of long term care facilities and other facilities, and in the interest of protecting the public health of the citizens of Alabama residing in these facilities, and to insure the availability of qualified and competent consultant pharmacist, the Board of Pharmacy hereby promulgates the following rules and regulations:

 

(a) Requirements:

1. The Board of Pharmacy shall maintain a roster of all pharmacist consultants of pharmaceutical services, solely directed in the area of consultation to health care professionals regarding medication/treatment regimens and not to include management consultation. All persons serving as consultants shall be a pharmacist registered and licensed by the State Board of Pharmacy in Alabama.

 

2. Location with on-site pharmacy: Any pharmacist consultant to long term care facilities, nursing homes, domiciliaries, homes of the aged, government agencies, and any other pharmaceutical consultation practice shall register initially and annually in each instance such practice with the Alabama State Board of Pharmacy on Forms provided by the Board.

 

3. Location without on-site pharmacy: Any pharmacist providing pharmaceutical consultation to, or coordinating pharmaceutical services, solely directed in the area of consultation to health care professionals regarding medication/treatment regimens and not to include management consultation, in long term care facilities, assisted living facilities, nursing homes, domiciliaries, homes for the aged, governmental agencies, and any other place where a pharmacy permit is not held shall register initially and annually in each instance such practice and place with the Alabama State Board of Pharmacy on forms provided by the Board."

 

DATE OF LAST SEMINAR ATTENDED (mm/dd/yy)     DATE OF APPLICATION (mm/dd/yy)

( * - All fields are required)