1 February 2011
This template application form to join a PCT’s pharmaceutical list has been developed by NHS PCC to assist PCTs and dispensing appliance contractors (DACs). It contains the information required by Part 1, Schedule 4 of the NHS (Pharmaceutical Services) Regulations 2005, as amended. PCTs should note that DACs are not obliged to use this template when applying to join their pharmaceutical list as long as they provide all the information required by the regulations, but it is hoped that DACs will find this template useful.
This template is only to be used where a DAC wishes to apply for new or additional premises to be included in a PCT’s pharmaceutical list. It is not suitable for use in other types of applications.
All rights reserved. All trademarks acknowledged.