The following form will be used when the pharmacy department wants to circulate a notification to all hospital wards and departments regarding update on the status of a certain medication after getting approval by the P&T committee to be added to the hospital formulary. The form is part of the main policy “Pharmacy formulary system policy” and this attachment serves as an example of the form, make sure to change the header and footer to better suit your organization design style, and add the proper dates of creation, modification and due to review date.
| HOSPITAL NAME – PHARMACY DEPARTMENT DRUG AVAILABILITY NOTIFICATION |
|---|
| Date: |
| The following medicine is now available in the pharmacy since it is approved by P&T committee to be added to the hospital drug formulary: |
| Generic name: Brand name: Dosage form: Strength: Manufacturer: Clinical pharmacological class: P&T committee approval date: |
Pharmacy supervisor
Signature / stamp:
Date:
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