SELF ASSESSMENT - MM3 Admin
CCOONNFFIIDDEENNTTIIAALL self ASSESSMENT Qualitative Inspection questionnaire for Services Provided in Community and Institutional Pharmacies PLEASE NOTE: The confidentiality of this document may be withdrawn should the information furnished lead to further investigation(s) Please refer this questionnaire for special attention: YES NO Encircle or mark applicable number/block with an Responsible Pharmacist or Pharmacist Initials/signature 2 self - ASSESSMENT questionnaire TABLE OF CONTENTS 1. DISPENSING PROCEDURES (CODE 0001) PHASE 1,2 & 3 2. COMPOUNDING OF AN EXTEMPORANEOUS ITEM (CODE 0002).
Encircle or mark applicable number/block with an ‘ ’ Responsible Pharmacist or Pharmacist Initials/signature 3 SELF-ASSESSMENT QUESTIONNAIRE 1. DDIISSPPEENNSINNGG OPPR ROCCEEDDUUREESS P((CCOODDEE 300 00011))1 –– PHHAASSEE …
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