Qualifications for Registration to Practice Telepharmacy Across Guam/State Lines

(a)An applicant applying for registration to engage in the practice of telepharmacy Across Guam/State Lines shall:

(1)present to the Board proof of licensure in another jurisdiction and proof that such license is in good standing;

(2)submit a written application in the form prescribed by the Board of Pharmacy;

(3)pay the fee(s) specified by the Board of Pharmacy for issuance of the license; and

(4)comply with all other requirements of the Board of Pharmacy. CH. 12 MEDICAL PRACTICES - PART I

(b)Application.

(1)The written application required under § 12617(a)(1) of this Act shall request of the applicant, at a minimum, the following information:

(A)name, address and current pharmacist licensure information in all other jurisdictions, including jurisdiction(s) of licensure and license number(s);

(B)name, address, phone number, and, if applicable, jurisdiction of licensure and license number of the site where the practice of telepharmacy will originate;

(C)a statement of the scope of patient services that will be provided;

(D)a description of the protocol or framework by which patient care will be provided, including any collaborative practice arrangements with other health care practitioners; and

(E)a statement attesting that the applicant will abide by the pharmacy laws and regulations of the jurisdiction in which the patient is located.