___________ HOSPITAL

PHARMACY SERVICES CONTRACT

THIS AGREEMENT, made and entered into this ___ __ day of ___________, by and
between __________ HOSPITAL, (herein after referred to as “Hospital”), and
________________, (herein after referred to as “Pharmacist”):

WHEREAS, Pharmacist is duly qualified as a registered pharmacist, and

WHEREAS, Hospital and Pharmacist are desirous of providing a full statement of

their respective rights, obligations and duties in connection with the operation of
the Hospital’s Pharmacy Department during the term of this Agreement,

NOW, THEREFORE, for and in consideration of the premises and of the mutual
covenants and agreements herein contained, the parties hereto agree as
follows:

1. The Pharmacist will make daily trips to the hospital during the week to control
and dispense pharmaceuticals in accordance with State Board of Pharmacy
rules.

2. The Pharmacist will maintain responsibility for issuing drugs, chemicals,

pharmaceuticals; filling and labeling drug containers issued to other hospital
departments; inspecting all drugs and pharmaceuticals in all hospital
departments; maintaining the approved stock of drugs; issuing all narcotic
drugs and alcohol and maintaining a perpetual inventory of them;
maintaining records which are required legally; supervising the maintenance
of the facilities of the pharmacy; maintaining current information on state
and federal laws pertaining to drugs and drug handling and keeping hospital
administration properly informed.

3. The Pharmacist will furnish information concerning medications to physicians

and nurses.

4. The Pharmacist will participate in formulating pharmacy policies and carrying

them out in accordance with the established policies of the hospital.

5. The Pharmacist will cooperate in inservice programs relating to the

pharmacy.

6. The Pharmacist will implement the recommendations of the Pharmacy and

Therapeutics Committee.

7. The Pharmacist will develop and maintain an updated hospital drug

formulary jointly with the medical staff.
PHARMACY CONTRACT
Page 2

8. The Pharmacist will maintain strict control over the dispensing of pharma-
ceuticals, including:

a. Dispensing of drug items in accordance with written physician orders

daily.

b. Review and supervision of drugs dispenses by charge nurses when the

Pharmacist is absent from the pharmacy.

c. Monitoring of narcotics records monthly.

d. Monitoring of drug stocks located outside the pharmacy on a routine

Basis, including items stored in ER, crash cart and nurses station.

9. The Pharmacist will ensure that all vials/containers of predispensed

Medication bear an expiration date.

10. The Pharmacist will be reimbursed for consulting Pharmacist services at the
rate of $ per hour, payable by the 15th of each month upon submission
of a statement by the 5th of each month.

The term of this agreement shall be two years. The agreement will be reviewed
by both parties at the end of the two year period to determine if any additions or
changes are required.

Either party may terminate this agreement with thirty (30) days written notice.

The undersigned agree to the provisions set forth in this contract.

______________________________________________ ____________________________
Pharmacist Date

______________________________________________ ____________________________
Administrator, __________ Hospital Date

pharmacy