New york form pharmacy 2025

1. Click ‘Get Form’ to open the New York Form Pharmacy in the editor.
2. Begin with Part I, where you will need to print in black ink. Check the appropriate box for registration type: Full Store or Department.
3. Fill in the name of the owner or corporation under which registration is sought, along with the trade name if applicable.
4. Provide the pharmacy address, including street, city, county, state, and zip code.
5. Complete one of the options regarding your pharmacy's status: new pharmacy, transfer of ownership, change of location, or renovation. Be sure to include relevant dates and previous registrant information if applicable.
6. Indicate your pharmacy specialty by checking all that apply from the provided list.
7. Answer questions about facilities such as sinks and security systems by selecting 'Yes' or 'No'.
8. List your daily schedule of hours that the pharmacy will be open.
9. In Part II, draw a scale diagram of your proposed pharmacy layout indicating all required areas and dimensions.
10. In Part III, affirm that all information is true by signing and dating the form. Ensure you provide contact information in Part IV for any clarifications needed.

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