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.
- 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
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 Self-Inspection Form
- Retail Pharmacy – Initial / Primary Site Inspection Form (for New Pharmacies)
- Institutional Pharmacy Inspection Form
- Institutional Pharmacy Self-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
Portable Document Format (.pdf). Visit nh.gov for a list of free .pdf readers for a variety of operating systems.
Office of Professional Licensure and Certification
121 South Fruit Street | Concord, NH 03301
Main Telephone: (603) 271-2152