Self-Assessment Forms - Current Versions - CA St Board of Rx

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Updated December 7, 2018

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• Self-Assessment Forms - California State Board of Pharmacy

- -  original post follows below  - -

The California Board of Pharmacy announced*:

"Board regulations (Title 16 California Code of Regulations sections 1715 and 1784), require that all licensed pharmacies and wholesalers complete a Self-Assessment by July 1 of every odd-numbered year.

The board recently updated the Self-Assessment forms through a formal rulemaking. The updated forms contain references to statutory and regulatory changes that occurred between 2011 and 2014 (inclusive).

While the rulemaking process was underway, the board accepted from pharmacies, hospital pharmacies and wholesalers completion of either the 2011 version OR the draft 2014 version: both versions have been available for use on the board’s website.

On April 20, 2016, the Office of Administrative Law approved the revised self-assessment forms. These forms can be downloaded at: http://www.pharmacy.ca.gov/licensees/facility/self_assess.shtml  They will all have “(Rev. 10/14)” date on them in in the lower left corner of the pages.

Form 17M-13: “Community Pharmacy Self-Assessment/Hospital Outpatient Pharmacy Self‐Assessment (Rev. 10/14)”
Form 17M-14: “Hospital Pharmacy Self‐Assessment (Rev. 10/14)”
Form 17M-26: Form 17M-26: “Wholesaler Dangerous Drugs & Devices Self-Assessment (Rev. 10/14).”

The board encourages all pharmacies, hospital pharmacies and wholesalers to complete the revised forms if they have not already completed the 2014 assessments. The board will no longer accept the 2011 versions of the self-assessment forms as [compliant]."

* Source:
California State Board of Pharmacy Subscriber Alert - emailed to PHARM-GENERAL@DCALISTS.CA.GOV on April 25, 2016.

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California Designated Representative Training Courses (wholesaler, 3PL) - Approved by the California State Board of Pharmacy

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For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training  
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Examination Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute