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Forms 31 to 60

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F31) RP absences

This sheet is a list of the jobs that can and can’t be done when the Responsible Pharmacist (RP) is absent.

F32) Records should be kept this long

This details the length of time various compulsory records that have to be kept before they can be destroyed

F33) Expiry Date Checking Sheets

This form is divided into sections of the dispensary e.g. generics A-G, F-M, M-Z with dates so that you can record which sections of your dispensary stock were last date checked. You then keep this record to show your inspectors. A quicker way is to put a dot on every item in your pharmacy on just one day of the month and then repeat with different coloured dots on the same date of the following months. After two months items will have 0,1,2, or 3 dots. Those with 3 dots you haven’t sold or dispensed in 2 months so don’t reorder and if possible sell off to ease cash flow.

F34) Complaints flyers and forms for public

This consists of two parts. Firstly the complaints flyer to give out to your clients and then forms for them to fill if they have comments, good or bad, they wish you to know about

F35) Annual Complaints Report Form

This is the form that you have to return to the LAT by the 31st of March of year to show how many complaints you received and the outcomes. It has to be completed and returned even if you had no complaints

F36 ) RP Display Certificate

This is the display certificate that you must have in easy sight of the public when you are operating as a RP. It is adaptable so if a locum turns up. Having forgotten his certificate you can make one for him.

F37) RP Absence Log

This sheet is to record dates and times of absences of the Responsible Pharmacist (RP). The allowance is for 2 hours out of 24 and the time runs from midnight to midnight. If the day is split between two or more RPs the allowance is still a combined two hours.  There is space on the form to record the reason for the absence but it is not compulsory

F38) Staff Competency Forms

This is where you record the qualifications and duties of your staff at a certain date and must be available to incoming RPs to make comments on their performance and review other RP comments. If several different RPs have suggested a member of staff is not performing well the superintendent should make every effort to retrain that person until their performance is acceptable. It must be updated on a regular basis

F39) SOP amendments Audit Trail

This is where you record any changes that you have made to SOPs in the light of say a change in ownership, an incident or a change in the law. It states what the SOP said beforehand, what it has been changed to, why the change was made and space for staff member to sign to say they will follow the new arrangements.

F40) Locum Booking Form

These forms are to be completed when you book a locum, especially if they are new to you, telling them what their hours are, where your SOPs and RP logs are kept, any functions that are done before they arrive or after they leave which they might be responsible for etc.


F41) Anticoagulant Record

The form where you record the details that are required such as whether the patient has a yellow book, understands it, the last date their INR was checked etc. before you can dispense a prescription for an anticoagulant, particularly warfarin.

F42) Nursing Home Visit Checklist

Designed for those who still deal with nursing homes as an aide memoire of things that need to be checked in preparation for a CQC visit.

F43) Shop Layout Plan

You will need one of this to record your fire exits, fire extinguishers, assembly points, electrical points, etc. You then put this up on the shop floor so you and your clients can familiarise themselves with it.

44) Locum Invoice

A form your locums can use to claim the payments they think are due from you including mileage and parking. Do it on the computer and the calculations are done for you.

F45) Locum Feedback Form.

This is designed for your staff to quickly fill in after a locum has gone so you can consider whether you wish to re-employ them.

F46) Information Sheet for the Locum

This should record where your SOPs, RP log, CD keys are kept, passwords for the computer, any procedures that are performed before they arrive of after they leave for which they may be responsible for, contact numbers etc.

F47) Appraisal Guidance for Employees

This gives details of what your employees should do before their appraisal so get the most out of the exercise.

F48) Appraisal Guidance for the Appraiser

This gives you, the employer, ideas of how to run an effective appraisal which can form the basis of an action plan for you and the employee for the future

F49) Appraisal Form.

A form that is easy to complete for you and the employee with all the information on a single double sided sheet so it is easy to store.

F50) Job Descriptions

Details of the main jobs within a pharmacy – the pharmacy manager, dispenser, counter assistant, driver with clear lists of the areas they will have responsibility for and chains of command

If you only want a couple of forms you can choose from those  below. They cost £12.09+vat each and delivery is exclusively by email.

F51) Staff Training Record Sheet

For recording training requirements of individual members of staff and details of their training.

F52) Confidentiality Clauses

Confidentiality agreements for companies and third parties you work with who have access to Patient Identifiable Information, with forms to record their details. 
F53) Methotrexate Toxicity Symptoms

Symptoms of Methotrexate Toxicity with warnings and recommendations. 
F54) Lithium Toxicity Symptoms

Symptoms of Lithium Toxicity with warnings and recommendations. 
F55) Hand washing during risk of Pandemic

Detailed guide on hand washing during a pandemic to display in your shop.
F56) CD leaflet for the patient

Patient Information leaflet with recommendations for storage and use of Controlled Drugs.
F57) Near Misses Report

For recording outcomes of meetings where Near Miss or Dispensing Errors have been discussed and solutions for error prevention have been agreed. 
F58) Emergency Contacts Sheet

For recording Emergency Contacts details (e.g. Electricians, Locksmiths, Emergency Services).
F59) Assignment sheets for data protection senior staff

For recording details of all Data Security and Protection staff.
F60) Staff Data Protection Questionnaire

Questionnaire to determine staff awareness and knowledge of Data Security and Protection protocols.

Buy your Forms now and don't forget, if you feel that they have not saved you time and money, just send them back for a full refund but please tell us why because we want to make sure we are always providing the gold standard of what our clients want.


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