Get Tx Lic-class_a-s 2019-2025

Completing the Texas pharmacy license application for community pharmacies engaged in compounding sterile preparations (Class A-S) can appear daunting. This guide provides a step-by-step approach to assist users in accurately filling out the application online.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to access the application form and open it in your preferred online document editor.
2. Indicate the type of application you are submitting by checking the appropriate box for a new pharmacy or a change of ownership. If applicable, provide the anticipated opening date or effective date of the ownership change.
3. Fill in the current pharmacy license number, if applicable, and other details such as the name of the previous pharmacy owner, the name of the pharmacy as listed on the license, and the physical address, including city, state, and zip code.
4. Complete the pharmacy information section, including the name of the pharmacy owner or legal entity, the business name, and contact information such as phone and fax numbers.
5. Provide the email address and web address of the pharmacy, select the type of ownership, and type of pharmacy, and list your hours of operation.
6. In the description of services section, check all services your pharmacy provides, including options for compounding and delivery. If your service is not listed, attach a detailed statement outlining your offerings.
7. Ensure the form contains the signature of the pharmacist in charge. This signature must be notarized, so make provisions for witnessing and notarization.
8. List all staff pharmacists and pharmacy technicians, providing their names and license or registration numbers. Attach an additional list if more space is required.
9. Answer the set of questions regarding professional disciplinary actions, accessibility for individuals with disabilities, translating services, and participation in the Texas Medicaid Program.
10. Review the entire application for accuracy. Ensure that all sections are filled out completely and correctly. Provide the signature of the owner or managing officer, which must also be notarized.
11. After completing the form, save your changes and ensure you download or print a copy for your records. Finally, send the completed application along with your fee to the Texas State Board of Pharmacy.

Complete your TX Lic-Class_A-S application online today for a streamlined process.