Get Ca 17m-14 2021-2026

This guide provides a step-by-step approach to completing the CA 17M-14 form online, ensuring clarity and ease of use for all users. The CA 17M-14 form is a self-assessment for hospital pharmacies mandated by California regulations.

Follow the steps to complete the CA 17M-14 form online.

1. Press the ‘Get Form’ button to access the CA 17M-14 form and open it for online completion.
2. Begin by filling in the pharmacy name and address in the designated fields. Make sure this information is accurate and reflects the current licensing status.
3. Indicate the ownership structure of the pharmacy by selecting the appropriate checkbox, such as Sole Owner, Partnership, or Corporation.
4. Complete the sections related to licenses, such as License Number, Expiration Dates, and any other relevant registration numbers. Ensure all details are correct.
5. List the pharmacy staff, including pharmacists, interns, and technicians, along with their respective license numbers and expiration dates. Ensure to add each staff member accurately.
6. Proceed to the self-assessment questions section. For each question, select 'Yes', 'No', or 'N/A' as applicable. If you select 'No', provide an explanation in the 'Corrective Action or Action Plan' area.
7. Review the responses to ensure all information is complete and accurate. If necessary, make adjustments before finalizing the form.
8. Upon completion, save your changes. You may also choose to download, print, or share the form as needed.

Complete your CA 17M-14 self-assessment form online today to ensure compliance with pharmacy regulations.