Instruction: 1. Make sure you have a clear folder for these documents Date Checked: __________________________ 2. Make sure you have soft copy of this in the computer Checked By : ___________________________
No. Item Checklist Remarks Yes No
1 LTO Application Form Properly filled out, notatirzed and with signature o o 2 Proof Of Business Registration DTI o o Business Permit Should be the same Address with LTO o o Barangay Clearance Should be the same Address with LTO o o COR from BIR o o 3 Credentials of Pharmacist and PA Pharmacist Pharmacist PRD ID o o Resignation Letter of Pharmacist from previous employer with signature of previous employer o o Resignation should have LTO No of previous employer indicating the LTO No of previous employer o o With seminar on licensing establishment for Drugstore o o Duties and Responsibilities of Pharmacist o o Pharmact Assistant Pharmacy Assistant Certificate of Training of Pharmacy Assts. post in the wall o o 4 Risk Management Plan Check the risk management plan if applicable to your drugstore Get from Lemuel SOP mandates by FDA make sure you always have a copy of this SOP mandates by FDA First page should always be signed in same year. Aftersales o o Cold Chain Management o o Dispensing make sure your PA knows this. o o Disposal of Expired Products, Product Return o o Good HouseKeeping make sure your PA knows this. o o Product Recall o o Purchasing make sure your PA knows this. o o Reporting of ADR o o Storage o o 5 Location Plan This should be the one with coordinates o o 6 Picture of Drugstore with Display Of Signage o o 7 Records of Sales Invoice from Supplier Hard copy ng sales invoice from Supplier o o 8 Prescription Book or e-file should be 2 years o o 9 Senior Citizen Book and PWD o o 10 Thermometer / Daily Reading o o 11 Organizational Chart should be displayed na makikita ng patient o o 12 GMAP o o MDRP o o Generic Flow Chart o o 13 Reference Materials Tell na me internet tayo. Check if this is valid answer RA 3720, PNDF, Standard Practice Guidelines o o Pharmacovigilance-related References o o o o