Providing contracted pharmacy services and pharmaceutical advice to the community of: Number of Staff Pharmacists Technicians Admin/Management/Retail Building Information (e.g. purpose built pharmacy constructed in 2012) Location of Hazard Register Relocation Site Preferences Two alternative sites if the service has to relocate, including one location outside your immediate area: 1. 2. Memorandum of Understanding (MOU) in place for the above two alternative sites? no yes If yes: (See Appendix 1 MOU template) – Name of Service: MOU covers: Name, address and Details of services to be key contact details provided
Providing contracted pharmacy services and pharmaceutical advice to the community of: Number of Staff Pharmacists Technicians Admin/Management/Retail Building Information (e.g. purpose built pharmacy constructed in 2012) Location of Hazard Register Relocation Site Preferences Two alternative sites if the service has to relocate, including one location outside your immediate area: 1. 2. Memorandum of Understanding (MOU) in place for the above two alternative sites? no yes If yes: (See Appendix 1 – MOU template) Name of Service: Name, address and key contact details MOU covers: Details of services to be provided