Compliance

The Board’s Compliance Department is involved in all matters regarding inspections, investigations, drug losses, diversion reporting, controlled drug destruction requests, questions on state pharmacy laws/rules, and all other issues related to the inspectional/investigative functions of the Board. Below you will find various Compliance forms and advisories. Please contact the Board at 603-271-2350 if you have any further questions.

Board Notices

• Changes to CII Prescriptions by Pharmacists 
• Policy on In-State Pharmacy Renovations / Remodels 
• October 23, 2017 Board Notice  
• Public Notice on Proper Handling of Sterile Compounded Products  

Forms

• NH Controlled Drug Loss Form  *This is the only acceptable form for reporting controlled drug losses to the NH Board of Pharmacy.
• Retail Pharmacy Self-Inspection Form 
• Institutional Pharmacy Self-Inspection Form 
• Self-Inspection Cover Letter and Instructions 
• Pharmacy Staff List for Self-Inspections 
• NH Regulations for Reporting Controlled Drug Losses to the Board 
• Federal DEA Site for Reporting Significant Controlled Drug Losses to the DEA (Online DEA 106 Form) *Not to be used for reporting controlled drug losses to the NH Board of Pharmacy – only to the DEA.
• Pharmacist Acknowledgement of PIC Exam Postponement Due To COVID-19 
• Template of Standing Order for Naloxone Dispensing at NH Pharmacies (provided by NH DHHS) 
• Quality Related Event (QRE) Report  
• Consultant Pharmacist's Record of Drugs Destroyed 
• Application to Place Controlled Drugs in Emergency Kits in Long Term Care / Specialized Care Facilities 
• Sign to Place Near Cash Registers at Pharmacies Where Pseudoephedrine Products Are Sold 

Links

• Food and Drug Administration (FDA) Purple Book: Lists of Licensed Biological Products with Reference Product Exclusivity and Biosimilarity or Interchangeability Evaluations

Sample Inspections Forms

In the spirit of full transparency, and to offer insight to licensees/registrants on the items the Board looks for during site inspections, below are sample inspection forms for your reference.

• Pre-Inspection Checklist 
• Retail Pharmacy Inspection Form 
• Retail Pharmacy – Initial / Primary Site Inspection Form  (for New Pharmacies)
• Institutional Pharmacy Inspection Form 
• Long Term Care Pharmacy Inspection Form 
• Drug Manufacturer / Wholesaler / Distributor Inspection Form 
• Drug Manufacturer / Wholesaler / Distributor Initial / Primary Site Inspection Form  (for New Faclities)
• Retail Medical Gas / Device Distributor Inspection Form 
• Methadone Clinic Inspection Form 
• Public Health Clinic Inspection Form 
• Practitioner Clinic Inspection Form 
• USP 795 / 797 Institutional Compounding Inspection Form 
• Home Infusion / Sterile Compounder Inspection Form