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DocuSign Envelope ID: DBD63D3B40414066BA924BAF5D8460BDCollaborative Pharmacy Practice Agreement for PharmacistAdministered Vaccines This Collaborative Pharmacy Practice Agreement (Agreement) is made

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How to fill out collaborative pharmacy practice agreement

01

Review state regulations regarding collaborative pharmacy practice agreements (CPPAs)

02

Identify a collaborating physician or healthcare provider

03

Establish roles and responsibilities for both the pharmacist and collaborating provider

04

Determine the scope of practice and specific activities allowed under the CPPA

05

Draft and review the CPPA document with all involved parties

06

Sign the CPPA document and ensure all parties have copies for reference

07

Periodically review and update the CPPA as needed

Who needs collaborative pharmacy practice agreement?

01

Pharmacists who wish to provide advanced clinical services such as medication therapy management (MTM)

02

Pharmacists who want to expand their scope of practice beyond traditional dispensing roles

03

Healthcare facilities looking to enhance patient care and outcomes through collaborative efforts between pharmacists and other providers

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What is collaborative pharmacy practice agreement?

Collaborative pharmacy practice agreement is a written agreement between a pharmacist and a physician that allows the pharmacist to provide certain patient care services under the authority of the physician.

Who is required to file collaborative pharmacy practice agreement?

Pharmacists and physicians are required to file collaborative pharmacy practice agreements.

How to fill out collaborative pharmacy practice agreement?

Collaborative pharmacy practice agreements can be filled out by both the pharmacist and the physician involved, detailing the scope of services to be provided.

What is the purpose of collaborative pharmacy practice agreement?

The purpose of collaborative pharmacy practice agreement is to improve patient care by allowing pharmacists to take on certain responsibilities traditionally held by physicians.

What information must be reported on collaborative pharmacy practice agreement?

Collaborative pharmacy practice agreements must include details on the services to be provided, the names and contact information of the pharmacist and physician, and any other relevant information.

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