64J-4.005. Patient Eligibility and Dispensing Requirements  


Effective on Sunday, February 13, 2022
  • 1(1) A repository must collect from each eligible patient, a completed DH9005-EPCS-07/2021 “Patient Application and Dispensing Form”, which is incorporated by reference and available at 26https://www.flrules.org/Gateway/reference.asp?No=Ref-1398428.

    29(2) The repository must maintain a physical or electronic record of each completed Patient Application and Dispensing form and submit copies of all forms for the previous month to the Department of Health by email at PrescriptionDrugDonationProgram@FLHealth.gov or mail to DOH Bureau of Public Health Pharmacy, Drug Donation Program, 104-2 Hamilton Park Dr., Tallahassee, FL 32304 by the 5th day of each month.

    92Rulemaking Authority 94465.1902(8)(b), 95(13) FS. Law Implemented 99465.1902 FS. 101History–New 2-13-22.