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COMMUNITY PHARMACY SMOKING CESSATION SERVICE FOR OFFICE USE ONLY Pharmacy ID number: TO BE COMPLETED BY THE CLIENT 1 Name: Male Female 12 70 If you are female, are you pregnant? YES NO UNKNOWN WHICH
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How to fill out mds_community_pharmacy_form_jan2009_1pdf_1:
01
Start by opening the PDF file of the form on your computer.
02
Carefully read all the instructions provided on the form to understand the purpose and requirements.
03
Begin by entering the necessary personal information in the designated fields, such as your name, address, phone number, and email address.
04
If applicable, indicate your pharmacy's information, including the name, address, and contact details.
05
Fill in any additional information or questions as instructed on the form. This may include sections related to certifications, licenses, or specific pharmacy services provided.
06
Double-check all the information entered for accuracy and completeness. Make sure to verify spellings, dates, and contact details before moving forward.
07
If required, attach any supporting documents or paperwork as indicated on the form. This could include copies of licenses or certificates.
08
Once you have filled out all the necessary fields and attached any required documents, save a copy of the completed form on your computer for your records.
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Print out the form if necessary, and sign it in the designated section.
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Review the form once again to ensure everything is accurate and complete, and then submit it as per the instructions provided on the form or to the relevant authority.
Who needs mds_community_pharmacy_form_jan2009_1pdf_1:
01
Pharmacists or pharmacy owners who operate community pharmacies and need to update their information with the appropriate regulatory authorities.
02
Individuals looking to open a new community pharmacy and seeking to fulfill the necessary licensing and registration requirements.
03
Regulatory agencies or government bodies responsible for overseeing community pharmacies and requiring the completed form for record-keeping or regulatory purposes.
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mds_community_pharmacy_form_jan2009_1pdf_1 is a form used by community pharmacies to report certain information to regulatory authorities.
Who is required to file mds_community_pharmacy_form_jan2009_1pdf_1?
All community pharmacies are required to file mds_community_pharmacy_form_jan2009_1pdf_1.
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What is the purpose of mds_community_pharmacy_form_jan2009_1pdf_1?
The purpose of mds_community_pharmacy_form_jan2009_1pdf_1 is to collect and report relevant information about community pharmacies for regulatory and compliance purposes.
What information must be reported on mds_community_pharmacy_form_jan2009_1pdf_1?
Information such as pharmacy name, address, contact information, services provided, and any violations or incidents must be reported on mds_community_pharmacy_form_jan2009_1pdf_1.
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