I/we propose to carry on at the above premises, the business in the course of which the above owner is providing pharmaceutical services at the above premises. These premises are currently in my/our possession* Yes No * by rental, leasehold or freehold 3 Opening hours 3.1 Proposed core opening hours Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total 3.2 Total proposed opening hours Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total 4 Pharmaceutical services to be provided at these premises Essential services (paragraphs 3 to 22, Schedule 4 pharmacies) – Or Terms of service (paragraphs 3 to 12, Schedule 5 DACs) – Clinical governance (paragraph 28, Schedule 4 - pharmacies or paragraph 18, Schedule 5 - DACs) If you are undertaking to provide appliances, specify the appliances that you undertake to provide if the pharmacy does not provide appliances). (or write ‘none’
I/we propose to carry on at the above premises, the business in the course of which the above owner is providing pharmaceutical services at the above premises. These premises are currently in my/our possession* Yes No * by rental, leasehold or freehold 3 Opening hours 3.1 Proposed core opening hours Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total 3.2 Total proposed opening hours Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total 4 Pharmaceutical services to be provided at these premises Essential services (paragraphs 3 to 22, Schedule 4 – pharmacies) Or Terms of service (paragraphs 3 to 12, Schedule 5 – DACs) Clinical governance (paragraph 28, Schedule 4 - pharmacies or paragraph 18, Schedule 5 - DACs) If you are undertaking to provide appliances, specify the appliances that you undertake to provide (or write ‘none’ if the pharmacy does not provide appliances).
12-annex-2-jul16.docx