Get Dh Mqa 1214 Form

Filling out the Dh Mqa 1214 Form online is a crucial step for anyone seeking a community pharmacy permit in Florida. This guide provides a comprehensive overview and step-by-step instructions to ensure your application process is smooth and efficient.

Follow the steps to complete your application online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully read all instructions provided in the form. This section contains essential guidelines that will assist you throughout the application process.
3. Fill out the application type by selecting one option: New Establishment, Additional Permit Type, Change of Location, or Change of Ownership. Each selection has a corresponding fee, so ensure to check the fee highlighted.
4. Complete the Business Information section, which includes the Corporate Name, Doing Business As (d/b/a), Mailing Address, and Physical Address. Make sure to verify the accuracy of each entry.
5. Enter the Prescription Department Manager's details, including their name, license number, start date, and signature.
6. Provide the necessary ownership information. Indicate the type of ownership, details of all owners and officers, and ensure that identification is submitted where required.
7. Submit fingerprint results if required. All necessary parties must have their fingerprints recorded and submitted, unless the business is exempt based on certain conditions.
8. Review the Attestation for Business Taxable Assets section and provide the required documentation if the business meets the specified conditions.
9. Ensure all questions are answered thoroughly. If any question requires an explanation, use a separate sheet as instructed.
10. Once the form is fully completed, save your changes. You have the option to download, print, or share the completed form as needed.

Begin filling out your Dh Mqa 1214 Form online today to ensure a timely application process.