Collaborative Drug Therapy Management Agreement Template 2025

1. Click ‘Get Form’ to open the Collaborative Drug Therapy Management Agreement Template in the editor.
2. Begin by filling in the names of the pharmacist(s) and collaborating physician(s)/NP(s) at the top of the form. This establishes the parties involved in the agreement.
3. In the introduction section, provide details about the specific CDTM protocol and clinic name. This contextualizes the agreement for all parties.
4. Proceed to complete the 'Referrals' section, ensuring that you outline how patients will be referred to clinical pharmacy services, including necessary information like diagnosis and goals of therapy.
5. Fill out any relevant sections regarding patient exclusion criteria, pharmacist qualifications, and documentation processes as outlined in the template.
6. Finally, ensure both parties sign and date at the bottom of the document. You can add multiple signature lines if needed for additional pharmacists.

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