Get Ks Form Ba-60 2017-2026

Filling out the KS Form BA-60 is a necessary step for notifying the State Board of Pharmacy about the closure of a pharmacy. This guide will provide you with a clear, step-by-step approach to completing the form accurately and efficiently.

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

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Enter the name of the closing facility in the designated field. This should accurately reflect the name under which the pharmacy operates.
3. Input the Kansas registration number associated with the pharmacy. Ensure this number is correct to avoid processing delays.
4. Provide the physical address of the pharmacy, including city, state, and zip code.
5. Indicate the closure date by selecting the appropriate date from the calendar tool or typing it in. Be sure that this information is accurate.
6. Specify whether the facility holds a Retail Dealer Permit by selecting 'Yes' or 'No'.
7. Enter the name of the person responsible for the pharmacy closure, followed by their phone number for contact purposes.
8. Fill in the details for the facility receiving patient files and records, including name, registration number, and physical address.
9. Proceed to provide the contact information of the facility receiving remaining stocks of drugs, ensuring accuracy in all fields.
10. Review the owner certification statement and provide your printed name, signature, date signed, and email address to certify the information provided is correct.
11. After filling out all required fields, save your changes, download the completed form, or print a copy for your records.

Complete your KS Form BA-60 online today to ensure compliance with pharmacy closure regulations.