Self-Assessment Forms
The assessment shall be performed before July 1 of every odd-numbered year. The self-assessment forms must remain on-site at the facility. Only submit the form to the board if requested by board staff.
The board is in the process of updating the Self-Assessment forms through a formal rulemaking. The updates include references to statutory and regulatory changes that occurred between 2014 and 2016. The last time the forms were formally updated was 2014.
Current regulation requires a pharmacy or wholesaler to complete the 2014 version of the Self-Assessment form. Please be advised, however, the board will accept completion of either the 2014 version OR the 2016 version. The latter version is likely to be a more helpful assessment to the pharmacy or wholesaler completing it.
Draft Self-Assessment Forms (Under Review for Possible Adoption)
- Community Pharmacy / Hospital Outpatient Self-Assessment (17M-13 Rev. 10/16)
- Compounding Self-Assessment (17M-39 Rev. 12/16)
- Hospital Pharmacy Self-Assessment (17M-14 Rev. 10/16)
- Wholesaler Dangerous Drugs & Dangerous Devices Self-Assessment (17M-26 Rev. 10/16)