Get Ct Application For A Change Of An In-state Pharmacy Manager 2018-2025

Filling out the CT Application For A Change Of An In-State Pharmacy Manager is a crucial step in ensuring compliance with state regulations. This guide will provide you with detailed instructions on how to complete the form accurately and efficiently online.

Follow the steps to complete your application effectively.

1. Press the ‘Get Form’ button to access the document and open it in your preferred editor.
2. Fill in the pharmacy information section, including the pharmacy name, Connecticut pharmacy license number, street address, telephone number, city, state, zip code, and email address for correspondence.
3. Complete the outgoing pharmacy manager section by providing their name, Connecticut pharmacist license number, and the end and start dates relevant to their management tenure.
4. In the new pharmacy manager section, enter the name and email address designated for correspondence. You will also need to answer the questions regarding felony convictions and federal or state registration actions. If applicable, be prepared to attach statements with the necessary details.
5. Review your application for accuracy. Once all fields are completed, ensure that any additional documents are attached as required.
6. Sign the application in the designated area, where the new pharmacy manager certifies that all information provided is accurate. Include the printed name and date of signing.
7. Finally, save your changes, download, print, or share the completed form as needed, and mail it along with a check or money order for the application fee to the Department of Consumer Protection.

Start filling out your CT Application For A Change Of An In-State Pharmacy Manager online today to ensure compliance and maintain your pharmacy operations smoothly.