Get Ks Form Ba-60 2018-2025

Filling out the KS Form BA-60 is essential for notifying the State Board of Pharmacy regarding the closure of a pharmacy. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the KS Form BA-60.

1. Press 'Get Form' button to access the form and open it in the editor.
2. In the 'Closing Facility' section, enter the name of the pharmacy, followed by the Kansas registration number and physical address. Specify the closure date along with the city, state, and zip code. Indicate whether the facility holds a Retail Dealer Permit and if that dealer is closing. Provide a phone number for the facility.
3. Complete the 'Person Responsible for Pharmacy Closure' section. Enter their name, phone number, and email address.
4. Move to the 'Facility Receiving Patient Files & Records' section. Fill in the name of the receiving facility, its Retail Dealer Registration Number, Kansas Registration Number, physical address, city, state, phone number, fax, zip code, and email address.
5. In the 'Facility Receiving Remaining Stocks of Drugs' section, provide the facility name, county, Kansas Registration Number, physical address, city, state, phone number, fax, zip code, and email.
6. Complete the 'Owner Certification' section by signing your name, entering the date of signing, and providing your printed name and email address.
7. Review all sections for accuracy and completeness, ensuring that all supporting documentation is attached as necessary. Once satisfied, you can save your changes, download, print, or share the completed form.

Complete your KS Form BA-60 online today for an efficient filing process.