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Texas PDF Templates

Homepage Blank Texas Lic 018 PDF Template

Form Example

TEXAS STATE BOARD OF PHARMACY

333 Guadalupe Street, Ste. 3-600

Austin, Texas 78701

512-305-8021

512-305-8082 (fax)

www.tsbp.state.tx.us

NEW PHARMACY CHECKLIST

(Submit this form only after all the items on this checklist are complete)

PHARMACY NAME & LOCATION ADDRESS (Street, City, ZIP)

A building with space adequate for the size and scope of pharmaceutical services provided by the pharmacy.

An area dedicated for the prescription department, including an area suitable for confidential patient counseling if the pharmacy serves the general public.

Water supply exists.

Electrical supply exists

Fixtures (i.e. shelving, counter tops, etc.) for storage of drugs, equipment and supplies, necessary to operate a pharmacy have been ordered.

Does the prospective owner currently have ownership interest in any other pharmacy in Texas?

YES

NO

If yes, please provide the name and address of the pharmacy:

THIS FORM MUST BE SUBMITTED WITH ALL

NEW PHARMACY APPLICATIONS

LIC-018 (Rev. 08/04)

1 of 1

Common mistakes

  1. Incomplete Pharmacy Name and Location Address: Many applicants fail to provide a complete and accurate name and address for the pharmacy. This information is crucial for identification and licensing purposes.

  2. Neglecting to Confirm Adequate Facilities: Some individuals do not verify that the building has enough space for the pharmacy's operations. It's important to ensure that there is a dedicated area for the prescription department and patient counseling.

  3. Overlooking Essential Utilities: Applicants often forget to confirm the availability of necessary utilities, such as water and electrical supply. Without these, the pharmacy cannot function properly.

  4. Failure to Disclose Ownership Interests: A common mistake is not indicating whether the prospective owner has an ownership interest in another pharmacy in Texas. This information must be provided if applicable, as it may affect the licensing process.

Key takeaways

When filling out the Texas Lic 018 form, there are several important points to keep in mind. Here are key takeaways to ensure a smooth application process:

  • Complete the Checklist: Only submit the form after ensuring that all items on the new pharmacy checklist are fully completed. This helps avoid delays in processing.
  • Provide Accurate Information: Clearly state the pharmacy name and location address. Make sure the address includes the street, city, and ZIP code for proper identification.
  • Confirm Facilities: Ensure that the pharmacy has adequate space for its services. This includes a dedicated area for prescriptions and a confidential space for patient counseling.
  • Ownership Disclosure: If the prospective owner has an ownership interest in another pharmacy in Texas, it is crucial to disclose this information. Include the name and address of that pharmacy.

Following these guidelines will help facilitate the approval of your new pharmacy application.

Steps to Using Texas Lic 018

Completing the Texas Lic 018 form is an essential step in the process of establishing a new pharmacy. Following these instructions will help ensure that all necessary information is accurately provided, facilitating a smoother application process.

  1. Begin by downloading the Texas Lic 018 form from the Texas State Board of Pharmacy website.
  2. Enter the pharmacy name in the designated field at the top of the form.
  3. Fill in the location address, including the street, city, and ZIP code.
  4. Confirm that the building has adequate space for the size and scope of the pharmaceutical services you intend to provide.
  5. Ensure there is a dedicated area for the prescription department, which should include a space suitable for confidential patient counseling.
  6. Check that there is a reliable water supply and electrical supply available in the pharmacy.
  7. Order necessary fixtures, such as shelving and countertops, for the storage of drugs, equipment, and supplies required for pharmacy operations.
  8. Indicate whether the prospective owner has an ownership interest in any other pharmacy in Texas by selecting YES or NO.
  9. If you answered YES, provide the name and address of the other pharmacy in the space provided.
  10. Review the completed form to ensure all information is accurate and complete.
  11. Submit the form along with all required documents for your new pharmacy application to the Texas State Board of Pharmacy at the address provided on the form.