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Forms

This page contains forms to support the Accountable Officer legislation.

Declaration and Self- Assessment Form to be completed by Pharmacies

This form is to be completed annually by all pharmacies.
It has been introduced as one of the requirements arising from The Controlled Drugs (Supervision of Management and Use) Regulations (Northern Ireland) 2009.
The completed form must be retained in the front of the Controlled Drug register and will become part of the record-keeping which will be examined by the Pharmacy Inspectors during their visits.
The Departmental Inspectors will, through their reporting arrangements, provide assurances to the Board Accountable Officer relating to the management and use of controlled drugs in contracted community pharmacies


Nomination Form

All Designated Bodies are required under The Controlled Drugs (Supervision of Management and Use) Regulations (Northern Ireland) 2009 to nominate or to appoint an Accountable Officer and the Department must be notified of this appointment in writing.
Click on the link below to obtain a copy of the nomination form


Occurrence Report

This form was revised on 9 September 2010 to include a section for updates on previous concerns
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