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Department Use Blythe University of the State of New York THE STATE EDUCATION DEPARTMENT Office of the Professions New York State Board of Pharmacy Email: pharmbd@mail.nysed.gov www.op.nysed.gov/prof/pharm/APPLICATION

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How to fill out pharmacist collaborative drug formrapy

01

Obtain the pharmacist collaborative drug therapy agreement form from your state's board of pharmacy.

02

Fill out the required personal information such as name, address, and contact information.

03

Include information about your pharmacy, such as license number and location.

04

Specify the drugs and conditions for which the collaborative agreement is being established.

05

Outline the responsibilities of both the pharmacist and the prescriber in the agreement.

06

Sign and date the form, ensuring that both parties involved also sign and date.

07

Submit the completed form to the appropriate regulatory body for approval.

Who needs pharmacist collaborative drug formrapy?

01

Pharmacists who wish to collaborate with prescribers in managing drug therapy for patients.

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What is pharmacist collaborative drug formrapy?

Pharmacist collaborative drug therapy is a practice in which a pharmacist works with a physician to provide patient-specific drug therapy management.

Who is required to file pharmacist collaborative drug formrapy?

Pharmacists who are collaborating with physicians to manage drug therapy for patients are required to file pharmacist collaborative drug formrapy.

How to fill out pharmacist collaborative drug formrapy?

Pharmacists can fill out the collaborative drug formrapy by documenting the collaborative drug therapy management plan, patient information, drug therapy goals, and progress notes.

What is the purpose of pharmacist collaborative drug formrapy?

The purpose of pharmacist collaborative drug formrapy is to improve patient care outcomes through coordinated drug therapy management between pharmacists and physicians.

What information must be reported on pharmacist collaborative drug formrapy?

Information such as patient details, drug therapy management plan, drug therapy goals, medication monitoring, and outcomes must be reported on pharmacist collaborative drug formrapy.

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