Get Application Form For Retail Pharmacy - Moh Gov

Filling out the application form for retail pharmacy is a vital step for individuals looking to establish a pharmacy business. This guide provides a clear and structured approach to completing the application form effectively and efficiently.

Follow the steps to successfully complete the application form.

1. Click the ‘Get Form’ button to obtain the form and have it open for editing.
2. In the first section, 'IDENTITE DU PROPRIETAIRE RESPONSABLE', fill in the required details about the responsible owner. This includes their full name, date and place of birth, address, phone number, email, marital status, and nationality.
3. Proceed to the next section labeled 'QUALIFICATIONS DES AUTRES AUXILIAIRES (EMPLOYES)'. You need to provide information regarding your auxiliary staff. Fill in the names and qualifications for up to five employees.
4. In the following section, 'EMPLACEMENT DE L’OFFICINE', indicate the location of the pharmacy. Specify the province, district, sector, cell, and neighborhood or center where the pharmacy will operate.
5. Now, complete the section for 'NOM DE L’OFFICINE'. Enter the proposed name for your pharmacy.
6. In the section for 'MOTIVATION DE LA DEMANDE', provide a detailed explanation of your motivations for opening the pharmacy. This should clearly outline your purpose and objectives.
7. Next, in 'PIECES A JOINDRE', list all required documents that need to accompany your application. Ensure you have included a request letter addressed to the Minister of Health, relevant degrees, CV, identification, and any other specified documents.
8. Before submitting, review the declaration statement to ensure that all provided information is accurate. Sign and date the form at the bottom.
9. After completing the form, you can save any changes made, download the form for your records, print it if needed, or share it as per the submission requirements.

Complete your application form online today and take the next step in establishing your pharmacy.